Instruction: Generate impression based on medical findings.

Input: 69 years, Female. Reason: H/o esophageal stricture from chemo/radiation with G-tube, has not had BM in 1 week, evaluate for obstruction and G-tube position History: Nausea, vomiting Mildly increased lung volumes. Upper lungs are excluded from the filled view. Please see same day chest radiograph report for additional findings. G-tube is present with contrast filled balloon. Position cannot be confirmed without contrast injection. Surgical clip is noted adjacent to the G-tube.Nonobstructive bowel gas pattern. Above average stool burden. No evidence of free air. DJD of the spine. Deformity of right pelvis, likely posttraumatic.

Output: G-tube is present with contrast filled balloon. Position cannot be confirmed without contrast injection. Nonobstructive bowel gas pattern. Above average stool burden. No evidence of free air.


Instruction: Generate impression based on medical findings.

Input: Female, 19 years old.Reason: r/o infiltrate History: cough and fever Cardiomediastinal silhouette is normal.No pleural effusion or pneumothorax.No focal pulmonary opacities.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: ETT position History: ETT in place Endotracheal tube has been pulled back and terminates approximately 4.5 cm from the carina. Other iatrogenic devices, unchanged. No new focal pleural parenchymal opacity. No large pleural effusion or pneumothorax. Unchanged cardiomegaly.

Output: Lines and tubes, as above.


Instruction: Generate impression based on medical findings.

Input: 31-year-old female has long history of ulcerative colitis and decreased bodyweight has persistent pain in back deep and abdomen. Pain retroperitoneal area T10 to L2-3. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Excellent distention with oral VoLumen. No significant abnormality. Specifically, no bowel wall thickening or abnormal areas of enhancement. The fold pattern in the colon was normal. No evidence of submucosal fat deposition. No evidence of fat stranding in the mesentery. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality. No evidence of sacroiliitis.OTHER: No significant abnormality noted.

Output: Normal exam.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for change in bilateral pneumothoraces History: bilateral pneumothoraces, s/p right lung transplant Large partly loculated right pneumothorax with chest tubes in place. Small left pneumothorax, slightly decreased.Cardiomegaly and nonspecific airspace opacity with atelectasis.Tracheostomy tube and venous catheters unchanged.

Output: Persistent bilateral pneumothoraces, slightly decreased on the left.


Instruction: Generate impression based on medical findings.

Input: Reason: Aortic Aneurysm Repair History: Post Op Day 1 ET tube tip approximately 3 cm above the carina.Swan-Ganz catheter tip in the right descending pulmonary artery.Increased consolidation and atelectasis in the left lower lobe.

Output: Increased left lower lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: 50-year-old female presents for evaluation of lines and tubes. Endotracheal tube projects approximately 4 cm above the carina. Left-sided internal jugular venous catheter has been retracted, now projecting over the left brachiocephalic vein near the midline. Enteric tube tip projects over the gastric body.The cardiomediastinal silhouette is stable. Interval decrease in pulmonary edema. Left basilar opacities consistent with atelectasis. No large pleural effusion. Low lung volumes. No pneumothorax.

Output: Lines and tubes as described above. Interval improvement in pulmonary edema pattern.


Instruction: Generate impression based on medical findings.

Input: 57-year-old female for catheter surveillance prior to transplant CHEST:LUNGS AND PLEURA: Nonspecific groundglass opacities and subsegmental atelectasis in the right middle lobeMEDIASTINUM AND HILA: Thyroid gland is diffusely enlarged and extends nearly behind the sternum. Ultrasound may helpful for further evaluation of the thyroid.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nodular left adrenal gland is unchanged.KIDNEYS, URETERS: Nonspecific hypodense lesions in the kidneys are unchanged. Lack of IV contrast limits optimally these lesions.RETROPERITONEUM, LYMPH NODES: Nonenlarged multiple retroperitoneal lymph nodes are unchanged.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: Limited study due to lack of IV contrast. Significantly enlarged thyroid. Further evaluation with ultrasound is recommended.Nodular left adrenal gland and bilateral nonspecific hypodense renal lesions are stable. Small retroperitoneal lymph nodes are stable.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Bladder cancer post cystoprostatectomy. Creation of orthotopic neobladder October 20, 2013. Normal heart size. No visible pulmonary nodules or masses. No pleural fluid or pneumothorax. No visible lymphadenopathy.

Output: No acute pulmonary abnormality. No visible pulmonary metastases.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: Evaluate for effusion, infiltrate, ET Tube position History: Altered mental status, ICH Endotracheal tube is high, terminating 9 cm superior to carina. Repositioning is recommended. Nasogastric tube terminates inferior to the caudal margin of the image.Improved aeration left elbow. Stable mild cardiac enlargement. No interval pulmonary edema or pneumothorax.

Output: The endotracheal tube cuff is likely at the cords. Advancement is recommended.


Instruction: Generate impression based on medical findings.

Input: 87-year-old female presenting with SCC of the face, constipation and vaginal discharge. Evaluate for an enterovaginal fistula. Lack of IV contrast limits evaluation of solid organs and vasculature.CHEST:LUNGS AND PLEURA: Multiple ground-glass opacities are identified in bilateral lungs and were seen on the previous study. However, these opacities are larger on today's study. The largest of these opacities in the right lower lobe measures 17 mm in diameter (series 5, image 38) and previously measured 13 mm in diameter.MEDIASTINUM AND HILA: Unchanged left superior mediastinal lymphadenopathy. Reference left paratracheal lymph node appears stable and measures 14 x 12 mm (series 4, image 12). Centra venous catheter tip is seen in the distal superior vena cava.CHEST WALL: Bilateral axillary lymphadenopathy appears slightly more prominent on today's exam. Reference left axillary lymph node measures 2.6 x 2.9 cm (series 4, image 20), previously measuring 2.1 x 3.1 cm.Port-A-Cath is seen in the subcutaneous tissues overlying the left chest.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.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: Prominent retroperitoneal, gastrohepatic, and peripancreatic lymphadenopathy is seen, and is consistent with worsening metastatic disease.Atherosclerotic calcifications of the abdominal aorta and its branches are noted. BOWEL, MESENTERY: Mesenteric lymphadenopathy is seen.BONES, SOFT TISSUES: Degenerative disease of the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No evidence of rectovaginal fistula.BLADDER: No significant abnormality noted.LYMPH NODES: Periaortic lymphadenopathy as described above, consistent with progression of metastatic disease.BOWEL, MESENTERY: Mesenteric lymphadenopathy as noted above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1.The limitations of a noncontrast study, there is no evidence of rectovaginal fistula. Please consider vaginogram or fistulogram if clinical suspicion remains.2.Progression in the size of multiple pulmonary opacities with retroperitoneal and mesenteric lymphadenopathy, suspicious for worsening metastatic disease.


Instruction: Generate impression based on medical findings.

Input: 46-year-old female with HIV, PCP now presents with two days of shortness of breath fever cough and hypoxia. Evaluate for PE and other lung pathology. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Patchy multifocal bilateral groundglass opacities with upper lobe predominance without pleural effusion.  Bilateral pleural thickening.MEDIASTINUM AND HILA: The heart size is at the top normal. Mediastinal and submental lymph nodes noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Patchy multifocal ground glass opacities suggestive of infection, specifically Pneumocystis pneumonia/PJP.No evidence of pulmonary embolism.


Instruction: Generate impression based on medical findings.

Input: Reason: chest pain, shortness of breath History: chest pain, shortness of breath Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 18 years old.Reason: evaluate ett placement History: ett Minimal basilar subsegmental atelectasis.Moderate cardiomegaly.ET tube tip approximately 5 cm above the carina.An NG tube terminates in the stomach.Esophageal probe.

Output: ET tube tip approximately 5 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: 92 year-old male with history of consolidation seen on recent CT. Evaluate for aspiration. Moderate cardiomegaly. Right greater than left bibasilar pulmonary opacities are present. Small right pleural effusion. Tortuous aorta.

Output: Cardiomegaly, right greater than left bibasilar opacities, and small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Desaturation, no dyspnea, no fever. Crackles at bases rule out pneumonia/atelectasis. Right subclavian chest port tip at the SVC. Mild elevation of the left hemidiaphragm with adjacent opacity suggestive of atelectasis . No specific signs of pneumonia.

Output: Left basal opacity most consistent with atelectasis, correlate for history of prior aspiration event. Follow-up plain films may be obtained if the patient remains symptomatic to exclude development of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: 65 with neutropenic fevers History: fever Left basilar opacity and small to moderate size left pleural effusion again noted. Mild right basilar opacity, unchanged. Unchanged heart size. No pneumothorax. Unchanged right-sided PICC.

Output: Unchanged left basilar opacity and small to moderate size left pleural effusion as well as unchanged mild right basilar opacity..


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: Check swan placement History: swan ganz for ADHF Support devices are unchanged in position. Femoral Swan-Ganz catheter is unchanged in position, directed toward the central right pulmonary artery.Severe cardiomegaly not significantly changed. Mild perihilar opacities are stable. No interval pneumothorax.

Output: Femoral Swan-Ganz catheter is directed toward the right central pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: sob History: sob No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lines and tubes History: as above ICD leads and Swan-Ganz catheter unchanged code of the Swan-Ganz catheter is blurred by cardiac pulsation.Marked cardiomegaly with vascular redistribution but no sign of pulmonary edema.No new findings.

Output: Cardiomegaly with no acute change.


Instruction: Generate impression based on medical findings.

Input: 42-year-old male with chest pain and shortness of breath. Cardiomediastinal silhouette is unremarkable. No focal opacity or pleural effusion.No pneumothorax.

Output: No significant cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: pna, cardiomegaly, plerual effusions History: sob, chest pain Heart size normal.Low lung volumes with no specific evidence of infection or edema.No pneumothorax or pleural effusion.

Output: No specific evidence of infection or edema


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: LVAD, stroke symptoms - assess for infection History: LVAD, stroke symptoms - assess for infection Cardiomegaly status post sternotomy with LVAD and ICD, unchanged.Prior pulmonary opacities have not recurred, and there is no specific evidence of edema or pneumonia.

Output: LVAD and ICD. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: Evaluate for acute cardiopulmonary process History: chest pain Lungs clear.Heart size normal.No pleural effusion. No pneumothorax. Hyperexpanded lung fields.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: r/o PTX History: increasing work of breathing, increased O2 demand Stable right lower lobe consolidation and right pleural fluid.Patchy airspace opacity left lower lung zone suggestive of aspiration.Median sternotomy.No significant pneumothorax.

Output: Unchanged right lower lobe consolidation and right pleural effusion with left basilar opacity as well. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: ptx History: pleurisy Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No significant pneumothorax.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male 55 years old Reason: ETT placement; OG tube placement History: intubated Interval placement of ET tube with tip 5 cm above the carina.OG tube appears coiled in the esophagus.Focal air space opacity or pleural effusion.

Output: ET tube placement as above. OG tube coiled in the esophagus.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: r/o infection History: breast abscess Small lung volumes.No acute abnormality.Left PICC, tip in axillary region.

Output: Small lung volumes, otherwise unremarkable. Peripheral PICC tip location.


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: MaleReason for Study: Reason: Pneumothorax; Post device placement in EP Lab History: Post device placement in EP Lab Right-sided pacemaker unchanged.Stable cardiomediastinal silhouette with evidence of an aortic valve prosthesis.Mildly increased lung volumes suggest COPD.Blunting of the left costophrenic angle unchanged compatible with either small effusion or pleural thickening.No new pulmonary opacities identified.No evidence of a pneumothorax.

Output: No interval change. No evidence of a pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: lung transplant interval History: above Enlarging left pleural effusion further compressing the left lower lung zone.Stable right pleural effusion.Mild cardiomegaly.Tubes and catheters are unchanged.

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


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Intubated with IABP. IABP marker partially obscured, about 2.5 cm below the top of the aortic arch.Other tubes and lines similar in position.Continued improvement in groundglass opacities throughout the left lung and right base. Retrocardiac atelectasis. No pneumothorax.

Output: IABP marker about 2.5 cm below the top of the aortic arch. Improving pulmonary opacities suspicious for pulmonary hemorrhage.


Instruction: Generate impression based on medical findings.

Input: Reason: ARDS w/ ETT in place History: ARDS w/ ETT in place ET tube tip approximately 2 cm above the carina.Catheter tip in the SVC.Patchy bilateral airspace and interstitial pulmonary opacity, compatible with ARDS and/or pulmonary hemorrhage, not significantly changed allowing for differences in technique. No new findings.

Output: No significant change in pulmonary opacity compatible with ARDS or hemorrhage.


Instruction: Generate impression based on medical findings.

Input: CHEST: Extremely limited in field of view and range of coverage.LUNGS AND PLEURA: Mild subpleural reticulation unchanged.MEDIASTINUM AND HILA: No lymphadenopathy.CHEST WALL: Very limited, but no acute abnormality.UPPER ABDOMEN: Very limited.

Output: No significant abnormality noted in the extracardiovascular portions of the examination. Stable mild subpleural reticulation.


Instruction: Generate impression based on medical findings.

Input: 34-year-old female with metastatic gist tumor 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: Reference lesion in segment 8 measures 20 x 19 mm image number 84, series number 3. Second segment 5 reference lesion measures 11 x 11 mm image number 95, series number 3. These are stable compared to previous study. No new lesions in the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Stable hepatic metastases.


Instruction: Generate impression based on medical findings.

Input: 54 years, Female. Reason: prolonged ileus after surgery, evaluate for dilated stomach or incisional hernia History: obstipation Upright chest shows lungs to be clear. Slight relative elevation of the left hemidiaphragm. Mediastinal osseous and soft tissue structures are normal.There is marked dilatation and air-fluid levels in the transverse colon and splenic flexure. Surgical GI staple line is seen in the right abdomen suggestive of a right hemicolectomy. There is no evidence of excessive stool in the left colon the rectum to explain the dilatation. Given history of recent surgery this may represent persistent postoperative ileus. No intramural or free air.

Output: Postoperative persistent dilatation transverse colon and splenic flexure correlate clinically. No evidence of excessive stool.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for et tube position History: new admit w/ ettube ET tube tip approximately 5 cm above the carina.Left chest tube in place with no significant pneumothorax. Feeding tube tip in the stomach.Surgical drain projected over the left lower hemithoraxCardiomegaly with mediastinal widening, pleural effusions and basilar atelectasis.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female, 38 years old.Reason: evidence of PE or infection History: pleuritic chest pain No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: eval infiltrates History: breakthrough convulsions No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: chest tube placement History: s/p wedge resection Postsurgical changes related to recent wedge resection in the left upper lobe and left apical chest tube.Right superior paramediastinal nodule again seen.Low lung volumes and patchy basilar atelectasis.No pneumothorax.

Output: Post surgical changes of left upper lobe wedge resection without pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 77 yearsGender: MaleReason for Study: Reason: eval lung for infection History: productive cough Right Port-A-Cath with its tip in the SVC.Esophageal stent in place, however there has been proximal migration compared to a prior CT dated 1/31/15.Bilateral basilar scarring/discoid atelectasis.No focal areas of consolidation.No large pleural effusions.

Output: Mild basilar scarring/discoid atelectasis. No specific evidence of acute infection. Proximal migration esophageal stent.


Instruction: Generate impression based on medical findings.

Input: Reason: assess for pleural effusion re-accumulation History: shortness of breath Complete opacification of the left hemithorax with increased volume, consistent with a large pleural effusion and underlying atelectasis.ICD leads and coronary artery calcification unchanged.Multiple small nodules throughout the right lung compatible with metastases, confirmed on recent CT scan.

Output: Interval increase in a left pleural effusion with complete opacification of the left hemithorax.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: PICC line placement History: PICC line placement Cardiomegaly, with patchy interstitial and airspace opacities slightly improved in the left lower lobe behind the heart.ET tube tip approximately 6 cm above the carina.A Dobbhoff tube extends below the lower margin of the image, repositioned.An NG tube extends below the lower margin of the image.Right jugular catheter, tip in SVC. Right PICC coiled in axillary region before terminating in the subclavian.

Output: Dobbhoff tube repositioned. Right PICC coiled in axillary region before terminating in the subclavian. Improved left lower lobe consolidation.


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: MaleReason for Study: Reason: assess for pneumothorax s/p thoracentesis 55M progressive renal cell carcinoma with hypoxia, pleural effusion History: s/p thoracentesis Numerous pulmonary nodules with left pleural effusion and underlying left chest mass similar and appearance the prior exam.Volume loss in the left lung compatible with prior lobectomy.No evidence of a pneumothorax post thoracentesis.

Output: Numerous pulmonary nodules, large left pleural effusion, and underlying left chest mass unchanged. No evidence of a pneumothorax post thoracentesis.


Instruction: Generate impression based on medical findings.

Input: Female, 91 years old.Reason: hx breast cancer History: tachycardia Right pleural effusion or pleural thickening, unchanged.Otherwise, no significant abnormality.Heart size normal.No specific evidence of metastases.

Output: Right pleural effusion or pleural thickening, likely the latter and unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason for study: AML, neutropenic fever, cough. Left upper extremity peripheral catheter tip terminates at the level of the superior vena cava, unchanged. New left upper lobe small nodular opacities, suspicious for infection. Mild left basilar subsegmental atelectasis, unchanged. No pleural effusion or pneumothorax. Thoracic scoliosis.

Output: New small left upper lobe nodular opacities suspicious for infection. If clinically indicated, CT may be obtained for confirmation.Findings were discussed with Dr. Priya Mehta at 11:02 AM on 2/15/2016.


Instruction: Generate impression based on medical findings.

Input: 56-year-old female neovagina lung cancer. Please evaluate for disease prior to starting chemotherapy. CHEST:LUNGS AND PLEURA: Right upper lobe parenchymal mass measuring 14 x 10 mm image number 27, series number 3. No other lung nodules. Biapical scarring.MEDIASTINUM AND HILA: Large infiltrative mediastinal mass extending superiorly from the supraclavicular region, invading the neck and inferiorly towards the right hilum. At the level of the aortic arch the mass measures 5.1 x 4.7 cm image number 32, series number 3. SVC is very small in caliber and encased by the mass, however is patent. The extension of the mass into the neck will be dictated separately on the neck CT report. Additional mediastinal adenopathy is also present. A reference paratracheal lymph node measures 16 x 11 mm image number 43, series number 3.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: 28 by 25-mm metastatic lesion in the right lobe of the liver image number 101, series number 3. Another subcentimeter lesion is on image number 130, series number 3.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Benign-appearing right renal cyst. Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not well seen.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: Large mediastinal mass invading the neck and extending inferiorly to the level of the right hilum and encasing the SVC. Right upper lobe parenchymal lesion.Liver metastases.


Instruction: Generate impression based on medical findings.

Input: 49-year-old male with surgical removal of a granuloma within the neck , evaluate for possible sarcoidosis and interstitial lung disease LUNGS AND PLEURA: No evidence of pulmonary nodules or evidence of interstitial lung diseaseMEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy can be identified. There is no evidence of a pericardial effusionCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Normal CT the chest without evidence of sarcoidosis or interstitial lung disease.


Instruction: Generate impression based on medical findings.

Input: Reason: Intubated History: Intubated ET tube tip approximately 3 cm above the carina.Interval removal of a right jugular catheter with the catheter sheath in the area of the jugular vein.A more recent radiograph has been interpreted.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: 65-year-old male with severe emphysema. CT 6 months ago at outside hospital showed 6 nodules. Assess nodules and emphysematous changes. LUNGS AND PLEURA: Moderate to severe centrilobular emphysema is identified. Bilateral scarring is identified. Multiple micronodules are identified within both lungs. Some of these are calcified. However, the largest noncalcified nodule measures 7 mm in the right middle lobe (image 212/373). These are nonspecific at this size.MEDIASTINUM AND HILA: Coronary artery calcifications are present.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Multiple well-circumscribed hypodense lesions within the visualized portion of the liver likely represent cysts. Calcified gallstones. Small hiatal hernia.

Output: Multiple micronodules on a background of moderate emphysema. Largest nodule measures 7 mm in the right middle lobe. If the patient's previous CT is available, this may be submitted for comparison. Otherwise, a 6 month follow up exam is recommended.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: pneumonia in January, Mycoplasma History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

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


Instruction: Generate impression based on medical findings.

Input: Age: 80 yearsGender: FemaleReason for Study: Reason: s/p ivc filter removal, assess for ptx History: none There is borderline cardiac enlargement with atherosclerotic changes of the aorta.The lungs are clear.No pleural effusions.Median sternotomy is identified with fractures of the two most superior wires and evidence of a prior CABG.No evidence of a pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Female, 25 years old.Reason: pneumothorax History: mvc, right sided chest pain Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: No acute cardiopulmonary process on radiography. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 70 year-old male with metastatic bladder cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Retrosternal goiter with focal and asymmetric extension of the left lobe of the superior mediastinum best seen in image number 20, series number 4. Small mediastinal lymph nodes. Index prevascular lymph node measures 10 x 7 mm image number 39, series number 4. This is unchanged from previous study.CHEST WALL: No significant abnormalityABDOMEN:LIVER, BILIARY TRACT: A subcentimeter hypodensity in the right lobe is unchanged measures 9-mm in diameter on image number 92, series number 4.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: Index right external iliac lymph node is unchanged measuring 7 x 5 mm image number 160, series number 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Age: 75 yearsGender: MaleReason for Study: Reason: assess ETT position, pulmonary opacities History: s/p intubation Support devices unchanged.Cardiomediastinal silhouette stable.Perihilar/basilar opacities compatible with edema, atelectasis, and pleural effusions similar in appearance to the prior exam.Again noted are pleural-based masses with associated rib destructionNo new pulmonary opacities identified.

Output: Support devices unchanged with ET tube tip 4 cm above the carina. Stable cardiopulmonary appearance with pulmonary opacities and pleural effusions similar to the prior exam.


Instruction: Generate impression based on medical findings.

Input: Reason: Hypoxemia History: Hypoxemia Tracheostomy tube and venous catheter unchanged.Diffuse nonspecific airspace opacity suggestive of edema and/or ARDS.No new findings.

Output: Diffuse airspace opacities suggestive of edema/ARDS without significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Reason: 47 yo female with history of AML; pre-allo SCT evaluation History: evaluate Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Right PICC, tip in the SVC.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: chest pain, sob History: above There is mild left ventricular enlargement. Mediastinal silhouette is unremarkable. The lungs and pleural spaces are clear.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: RLL infiltrate History: cough and pain Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: cough History: cough Moderate cardiomegaly.Left lung base scarring, but no sign of edema or pneumonia.Blunting left costophrenic angle most likely is from pleural scarring rather than an effusion.An SVC stent is present.Left subclavian ICD, leads unchanged in position.

Output: No acute abnormality. Moderate cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Pleural biopsy recurrent right pleural effusion. Mesothelioma. Right pleural catheter similar in position. Right pleural thickening similar to previous. Loculated pleural fluid in the superior aspect of the right major fissure. Left ICD unchanged in position.Less than 5-mm right pneumothorax. Subcutaneous emphysema right chest wall.

Output: Small right pneumothorax component, less than 5-mm in size.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: eval line/lungs History: weakness Cardiomegaly unchanged. Right central catheter with tip at the cavoatrial junction. No specific evidence of infection or edema. No pleural effusion or pneumothorax.

Output: Right central catheter with tip at the cavoatrial junction. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Female, 34 years old.Hypoxia, chest pain with history of sickle cell disease. Evaluate for acute chest. Cardiomegaly is opacities suggestive of edema. Similar the prior exam. No new focal lung opacity to suggest infection. Small bilateral pleural effusions are unchanged.Vascular stents and position of right internal jugular chest port catheter unchanged.

Output: Stable cardiomegaly with mild edema and small pleural effusions. No new focal lung opacity to suggest infection.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male status post mechanical ventilation with restrictive PFTs. Late-phase DAD? LUNGS AND PLEURA: Mild, patchy subpleural reticulation, non-specific in appearance without honeycombing, groundglass or architectural distortion.MEDIASTINUM AND HILA: Coronary artery calcifications. Small mediastinal lymph nodes are not enlarged by CT criteria.CHEST WALL: Bilateral axillary lymph nodes are not enlarged by CT criteria.UPPER ABDOMEN: Subcentimeter hypodense lesions throughout the liver are too small to characterize but most likely simple cysts.

Output: 1. Mild nonspecific fibrosis possibly due to prior alveolar damage.2. Coronary artery calcifications.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Status post esophagectomy, please evaluate for pneumothorax. Mild cardiomegaly. Low lung volumes. Chest tube terminates in the left lung apex. NG tube tip terminates adjacent to the left hemidiaphragm. Surgical clips project over the left lower lobe. Skin staples are noted in the left neck and left upper quadrant. Right chest port catheter tip in the SVC. Streaky left basilar opacities likely represent atelectasis. No significant pneumothorax.

Output: Postsurgical changes without significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: Pre-kidney transplant evaluation/clearance History: Pre-transplant surgery Normal heart size with a tortuous ectatic aorta, unchanged.No significant pulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Chest pain. Normal heart size. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.Reason: ET tube History: intubated Lower lung zone edema and pleural effusions with left lower lobe consolidation, unchanged.Moderate cardiomegaly unchanged.ET tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.

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


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: pna History: cough Stable cardiomediastinal silhouette.No focal air space abnormality. No pleural effusion.

Output: No acute pulmonary abnormality. Specifically, no evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 85 years old.Reason: eval ngt History: NGT placed at OSH Mild left lung base subsegmental atelectasis, otherwise unremarkable.An NG tube terminates in the stomach, the side port at the GE junction level.

Output: An NG tube terminates in the stomach.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Productive cough question pneumonia. Normal heart size. No focal airspace opacities, pleural fluid or pneumothorax. Minimal subsegmental atelectasis superior segment right lower lobe seen on the lateral radiograph. Clustered nodular opacities at the left lung base are most consistent with endobronchial debris. Mild bronchial wall thickening.

Output: Minimal bronchial wall thickening, atelectasis and endobronchial debris suggesting bronchitis, but no specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: heart failure, evaluate for pulmonary edema, evaluate device Presternal defibrillator lead overlies the mediastinum. Probable right basilar pleural-parenchymal scarring. Focal scarring in the mid aspect the left lung. No focal lung consolidation or evidence of overt left-sided heart failure. Marked cardiomegaly noted. No pneumothorax.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.History: Chronic chest pain. Unremarkable cardiomediastinal silhouette.No focal pulmonary opacity or pleural abnormality.Interval resolution of left basilar interstitial abnormality.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 26 year old male with hypoxia, rule out acute chest. history of Hb-SS Patchy opacities and atelectasis in the right costophrenic angle which in retrospect appears increased from prior study. No pleural effusion or pneumothorax. Mild cardiomegaly.

Output: Mild cardiomegaly. Opacity in the right costophrenic angle may represent subacute infection or less likely infarction. This is at least mildly suspicious for acute chest syndrome.


Instruction: Generate impression based on medical findings.

Input: Female 31 years old Reason: r/o acute chest History: SOB. Cardiomediastinal silhouette is within normal limits.No focal opacity, pneumothorax, or pleural effusion is identified.Redemonstration of scarring/discoid atelectasis at the bases.Spinal changes consistent with sickle cell disease.

Output: No acute cardiopulmonary abnormality. No focal opacity to suggest acute chest syndrome.


Instruction: Generate impression based on medical findings.

Input: 19 years, Male. Reason: abdominal pain Surgical clips in the right upper quadrant. Nonobstructive bowel gas pattern. Average stool burden. No pneumatosis or pneumoperitoneum. No focal airspace opacity, pleural effusion or pneumothorax. Mild hepatomegaly. Mildly enlarged cardiac silhouette. Multilevel vertebral body loss of height likely due to history of sickle cell disease.

Output: No evidence of obstruction. Mild hepatomegaly, and mildly enlarged cardiac silhouette. Osseous changes of sickle cell disease.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: r/o pna History: chest pain Stable cardiomediastinal silhouette.The lungs are clear.No pleural effusions.Scoliosis of the thoracolumbar spine redemonstrated.

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


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: edema History: sob, weakness Small lung volumes with left base predominant opacity with a left effusion, similar to the prior study.Mild to moderate cardiomegaly with distention of the azygos vein.

Output: Basilar opacities suggestive of edema possibly with left basilar aspiration or simple atelectasis.


Instruction: Generate impression based on medical findings.

Input: 66-year-old male with bladder cancer CHEST:LUNGS AND PLEURA: Paraseptal emphysema. A spiculated left upper lobe mass measures 17 x 21 mm image number 25, series number 3. This lesion is suspicious for a primary bronchogenic carcinoma. Significant by apical scarring, more prominent on the right. Right upper lobe nodule measuring 7-mm in diameter image number 38, series number 3.Several scattered micronodules are also present in the lower lingula best seen on image number 45, series number 4.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes. A reference noncalcified lymph node anterior to the ascending aorta measures 16 x 13 mm image number 47, series number 3.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Several round cystic hypodense lesions in the pancreas. There afferents lesion measures 9-mm in the neck. These may represent small branch type intrapancreatic lesion is neoplasms. M.R.C.P. may be helpful for follow-up.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. There afferents centrally necrotic lymph node measures 11 by 9-mm image number 119, 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: Ill-defined enhancing mass in the basal to bladder measuring 2.4 x 2.1 cm image number 118, series number 3. This mass likely metastatic prostate. A separate additional enhancing small focus is also present in the left lateral wall of the bladder.LYMPH NODES: Left para-iliac necrotic adenopathy measures 20 by 10-mm image number 138, series number 3. Additional left obturator and left internal iliac necrotic lymph nodes are also present.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Severe osteoporosis involving the entire skeletal system..OTHER: No significant abnormality noted

Output: Left upper lobe spiculated lung mass suspicious for primary bronchogenic carcinoma. However bilateral nodules in both lungs suspicious for metastatic disease..Enhancing bladder mass.Retroperitoneal and pelvic adenopathy.Pancreatic cystic lesions. A follow-up M.R.C.P. in 6 months is recommended for further evaluation.


Instruction: Generate impression based on medical findings.

Input: Female, 40 years old.Concerning for worsening pneumonia. Diffuse bilateral heterogeneous and left basilar consolidative opacities, not significantly changed from recent comparison although improved from prior images at 3:39 AM on 9/12/2016.No pneumothorax.Stable adequate position of support apparatus.

Output: Findings suggestive of resolving pulmonary edema (likely noncardiogenic) superimposed on possible multilobar pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: PNA vs URI History: hypoxia Redemonstration of bibasilar interstitial opacities with more focal streaky opacity within the right lung base. No large pleural effusion or pneumothorax. Heart size is normal.

Output: Right greater than left bibasilar interstitial and streaky opacities which may reflect atelectasis and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: 22 years, Female. Reason: eval for acute process History: abd pain/constipation The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax is identified.Average to slightly increased volume of stool in the rectal vault. Nonobstructive bowel gas pattern.

Output: Average to slightly increased stool burden.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old, with history of amiodarone toxicity and Legionella, now with nodules. Concern for fungal infection. LUNGS AND PLEURA: Bilateral, predominantly lower lobe nodular opacities are redemonstrated. The reference nodule in the right lower lobe now measures 1.4 cm in diameter, increased from 8 mm. The reference left lower lobe nodule measures 12 x 9 mm, probably unchanged. Both demonstrate peripheral hazy groundglass opacity highly suggestive of fungal infection, likely invasive aspergillosis. A nodular opacity in the right lower lobe on axial image 57/110 is new.Peribronchial groundglass opacity persists and can be seen in aspiration, viral infection or hemorrhage. Debris within the left mainstem bronchus favors aspiration.MEDIASTINUM AND HILA: AICD leads in the right atrial appendage and right ventricle. Mediastinal surgical clips. Cardiac size is mildly enlarged. No pericardial effusion. Coronary artery calcifications. No significant change in small mediastinal lymph nodes.CHEST WALL: Left chest wall pacemaker generator. Median sternotomy wires. Sclerosis and mild compression deformity of the T4 and T6 vertebral bodies, unchanged. Deformity of the left T5 and T6 ribs suggestive of healed fractures.UPPER ABDOMEN: No significant abnormality noted.

Output: 1.Progression of nodular opacities highly suggestive of invasive fungal infection.2.Peribronchial groundglass most likely represents aspiration, although viral infection and hemorrhage may also be considered.


Instruction: Generate impression based on medical findings.

Input: Weakness and hypotension Interval removal of the right jugular catheter and previously identified Dobbhoff.Lungs demonstrate improved overall aeration with underlying minimal scarring. No discrete superimposed airspace abnormality however exam is limited due to semiupright portable technique and lack of a lateral projection, consider follow-up imaging if suspicion remains high for subtle abnormalities.Cardiac and mediastinal contours are within limits

Output: Node distinct acute cardiopulmonary abnormality within limitations observed


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: eval for possible PNA History: sob, consolidation on prior CXR Low lung volumes. Right middle lobe consolidation with associated atelectasis suspicious for pneumonia. No pneumothorax. Cardiomegaly unchanged.

Output: Consolidation right middle lobe suspicious for pneumonia with atelectasis.


Instruction: Generate impression based on medical findings.

Input: 11 mo M RSV bronchiolitis, pulmonary HTN, PTX s/p chest tube placement, intubated, eval for interval changes VIEW: Chest AP (one view) 2/5/2016 3:59 ET tube tip between thoracic inlet and carina. Feeding tube transpyloric outside the field-of-view. 2 left pigtail chest tubes in place. Right IJ tip in the SVC. Lower central line tip in the right atrium.Cardiothymic silhouette is normal. Continued subpulmonic left pneumothorax. Bilateral upper and left lower streaky opacities are stable. Increased lung volumes.

Output: Continued subpulmonic left pneumothorax. Increased lung volumes.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: r/o infiltrate History: cough No significant cardiopulmonary abnormality.No specific evidence of infection.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval of previously collapsed left lung History: eval of previously collapsed left lung. improved SOB/o2 req Increased atelectasis and consolidation in the left lower lobe.Perihilar bronchial thickening consistent with bronchitis and nonspecific airspace opacity at the right base compatible with infection or aspiration, not significantly changed.

Output: Increased left lower lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 91 years old.Reason: seizure History: ams Scarlike opacity right mid lung, probably benign but 6-12 month follow-up recommended.Moderate cardiomegaly.No specific evidence of infection or edema.

Output: Focal right midlung opacity, 6-12 month follow-up recommended. Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.Reason: iabp History: iabp Heart size normal, and no evidence of residual edema.IABP catheter proximal marker 1 cm below the top of the aortic arch.Right subclavian ICD unchanged.

Output: No acute abnormality. Stable devices.


Instruction: Generate impression based on medical findings.

Input: Neck mass with unknown primary squamous cell cancer. CHEST:LUNGS AND PLEURA: Few, scattered pleural scarlike opacities. No suspicious pulmonary nodules or masses. No focal consolidation, edema or pleural effusion.MEDIASTINUM AND HILA: No significant hilar or mediastinal lymphadenopathy. Cardiac size is normal with no pericardial effusion.CHEST WALL: Degenerative changes affect the spine.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedPANCREAS: 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 noted

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


Instruction: Generate impression based on medical findings.

Input: 93-year-old female with cough. Follow-up of left basilar pneumonia. Stable mild cardiomegaly.Significant improvement of basilar opacities and bilateral pleural effusions.Residual left basilar opacity.

Output: Residual left basilar opacity with interval improvement of basilar opacities and bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: 46-year-old male, history of ALL status post chemotherapy presenting with fevers, crackles right greater than left. Evaluate for infection. CHEST:LUNGS AND PLEURA: Patchy bilateral tree in blood and nodular opacities predominantly lower lobe with involvement in right middle and lingular segments are consistent with bronchiolitis or atypical infection such as mycobacterial or fungal.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right jugular central venous catheter in place with its tip at the SVC RA junction. Subtle mottling of the right fourth rib is unchanged.UPPER ABDOMEN: Within the limitations of this noncontrast examination, no gross abnormality is seen.

Output: Patchy bilateral tree and opacities predominantly lower lobe with involvement of right middle and lingular segments consistent with bronchiolitis or atypical infection such as mycobacterial or fungal.


Instruction: Generate impression based on medical findings.

Input: Reason: post op cardiac surgery History: line eval Marked cardiomegaly with a tortuous and ectatic aorta.Swan-Ganz catheter tip in the right main pulmonary artery.Interval extubation.Basilar opacities greater on the left compatible with atelectasis and small effusions.

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


Instruction: Generate impression based on medical findings.

Input: Status post thoracic aneurysm repair. Unchanged skin staples overlying the left hemithorax. Two left basilar chest tubes are unchanged in position. Right pigtail chest tube, unchanged. Small left pleural effusion and adjacent subsegmental atelectasis. No pneumothorax. The cardiomediastinal silhouette is within normal limits.Multifocal air-fluid levels within the abdomen may represent ileus pattern postoperatively.

Output: Small left pleural effusion with subsegmental atelectasis. Multifocal air-fluid levels within the abdomen may represent ileus pattern postoperatively.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: is there any pul edema History: hypertension history, present with elevated bp, no sob Cardiomegaly, with left basilar opacity consistent with compression atelectasis although infection is in the differential diagnosis.Equivocal edema right lung base, but no significant sized pleural effusions.

Output: No change in cardiomegaly with left lower lobe opacity suggestive of compression atelectasis, and only equivocal evidence of edema.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.S.O.B., intubated. Pleural fluid, atelectasis, edema and dependent consolidation, slightly increased on the left. Tubes and lines unchanged in position. No pneumothorax.

Output: Slight increase in consolidation in the left lower lobe, possibly related to prior aspiration event. Edema, pleural fluid and atelectasis not significantly changed on the right, minimally worse on the left.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for free air History: upright chest, fever No sign of free intraperitoneal air.Small lung volumes with basilar opacity compatible with atelectasis.

Output: Basilar atelectasis with no sign of free air.


Instruction: Generate impression based on medical findings.

Input: Chills, yet no fever A focal nodular density is observed in both the left and right midlung, approximate 1 cm on the left. The larger left nodule remains discrete and is also observed in the lateral projection overlying the descending aorta. Lungs otherwise clearThe cardiac and mediastinal contours are within limits given age

Output: Scattered multiple nodules, one larger on the left warranting follow-up comparison imaging to prove stability and or CT evaluation for further characterization, unless there is known underlying metastatic malignancy.Pager 7896 contacted


Instruction: Generate impression based on medical findings.

Input: Age: 37 yearsGender: FemaleReason for Study: Reason: Hypoxia post-procedure History: Sats <90 The cardiomediastinal silhouette is unremarkable. Decreased lung volumes with nonspecific basilar opacities compatible with atelectasis.No focal areas of consolidation.No large pleural effusions.

Output: Mild basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: 55-year-old female with diffuse large B-cell non-Hodgkin's lymphoma and thoracic epidural mass. This non-contrast examination is limited for the evaluation of solid organ pathology. Within that limitation, the following observations are made.CHEST:LUNGS AND PLEURA: Diffuse groundglass opacity in the lung bases is suggestive of edema.MEDIASTINUM AND HILA: Cardiac size is large but unchanged. No pericardial effusion. No significant hilar or mediastinal lymphadenopathy. A cardiac pacemaker is in place.Previously noted right paraspinal mass measures 1.6 x 3.3 cm on axial image 43/204 and is grossly unchanged.CHEST WALL: Left chest wall pacemaker generator.ABDOMEN:LIVER, BILIARY TRACT: Large, peripherally calcified gallstone is unchanged in appearance. No evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal calculi noted. A left lower pole renal calculus on axial image 109/204 was evident on the prior exam. No perinephric stranding, hydronephrosis or other evidence of obstruction.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: The uterus and ovaries are not identified and presumably have been resected.BLADDER: No significant abnormality noted.LYMPH NODES: A right external iliac lymph node measures 1.0 x 2.0 cm on axial image 176/204 and is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Stable examination with no evidence of disease progression or metastatic disease.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Angina, check lungs and lead placement Mediastinal left-sided chest tubes appear unchanged without associated pneumothorax. Swan-Ganz appears similar, however the ETT has been removed. The IABP marker is also not visualized consistent with removal, however motion may degrade sensitivityy.A new moderate right pleural effusion with mild basilar edema. Persistent mild cardiomegaly

Output: ETT and IABP removal


Instruction: Generate impression based on medical findings.

Input: Female, 99 years old.Hypertension, CAD, OA, DVT here with leukocytosis and cough. Small pleural effusions, left greater than right, unchanged. Coarse peripheral pulmonary opacities suggestive of fibrosis, progressed compared to the exam of 2014. Increased opacity in the bases may be due to infection or atelectasis.Retrievable IVC filter and a left nephroureteral stent are noted.

Output: 1. Small pleural effusions with basal opacities which may reflect atelectasis and/or superimposed infection. 2. Peripheral interstitial opacities highly suspicious for interstitial lung disease and have progressed since 2014. 3. The patient is noted to have a retrievable IVC filter which has been in place possibly since the abdominal scan of 10/2014; this was discussed with Dr. Natelborg via telephone at 7:17 a.m. on 5/27/2016


Instruction: Generate impression based on medical findings.

Input: 87-year-old female presenting with SCC of the face, constipation and vaginal discharge. Evaluate for an enterovaginal fistula. Lack of IV contrast limits evaluation of solid organs and vasculature.CHEST:LUNGS AND PLEURA: Multiple ground-glass opacities are identified in bilateral lungs and were seen on the previous study. However, these opacities are larger on today's study. The largest of these opacities in the right lower lobe measures 17 mm in diameter (series 5, image 38) and previously measured 13 mm in diameter.MEDIASTINUM AND HILA: Unchanged left superior mediastinal lymphadenopathy. Reference left paratracheal lymph node appears stable and measures 14 x 12 mm (series 4, image 12). Centra venous catheter tip is seen in the distal superior vena cava.CHEST WALL: Bilateral axillary lymphadenopathy appears slightly more prominent on today's exam. Reference left axillary lymph node measures 2.6 x 2.9 cm (series 4, image 20), previously measuring 2.1 x 3.1 cm.Port-A-Cath is seen in the subcutaneous tissues overlying the left chest.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.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: Prominent retroperitoneal, gastrohepatic, and peripancreatic lymphadenopathy is seen, and is consistent with worsening metastatic disease.Atherosclerotic calcifications of the abdominal aorta and its branches are noted. BOWEL, MESENTERY: Mesenteric lymphadenopathy is seen.BONES, SOFT TISSUES: Degenerative disease of the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No evidence of rectovaginal fistula.BLADDER: No significant abnormality noted.LYMPH NODES: Periaortic lymphadenopathy as described above, consistent with progression of metastatic disease.BOWEL, MESENTERY: Mesenteric lymphadenopathy as noted above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1.The limitations of a noncontrast study, there is no evidence of rectovaginal fistula. Please consider vaginogram or fistulogram if clinical suspicion remains.2.Progression in the size of multiple pulmonary opacities with retroperitoneal and mesenteric lymphadenopathy, suspicious for worsening metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 40 years old.Pulmonary edema. Right subclavian dual-lumen catheter; the distal catheter tip is directed medially at the expected location of the tricuspid valve, suggest repositioning.Tracheostomy tube tip at the level of the clavicular heads.Pleural fluid, edema and atelectasis about the same.

Output: Right subclavian dual-lumen catheter distal tip in the right atrium at the expected location of tricuspid valve, suggest repositioning. Unchanged pulmonary edema and pleural fluid.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Cough, shortness of breath The cardiac silhouette is unremarkable. Low lung volumes and basilar atelectasis without specific evidence of infection or edema. Unchanged blunting of the right posterior costophrenic angle is likely related to scarring.Opacity at the medial left hemidiaphragm compatible with a Bochdalek hernia.

Output: Low lung volumes without acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Right chest pain, worse with movement The cardiac and mediastinal silhouette is normal.No specific evidence of infection, edema, or effusions.No displaced rib fracture.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female 75 years old Reason: 75 yo F with COPD with LLL PNa, eval for resolution History: as above Large lung volumes with flattened hemidiaphragms.Stable cardiomediastinal silhouette.Near interval resolution of retrocardiac left lower lobe basilar opacities.No significant pleural effusions.

Output: Near interval resolution of left lower lobe retrocardiac basilar opacities suggestive of resolving pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old. Reason: ETT moved History: ETT pulled back 2cm Endotracheal tube terminates approximately 5.5 cm from the carina. Other lines and tubes, unchanged. Bibasilar opacities and small pleural effusions with mild pulmonary edema. Right hilar fullness/mass again noted. Unchanged heart size.

Output: Small pleural effusions with bibasilar opacities and mild pulmonary edema. Endotracheal tube, as above.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: 75yo M w/ fever, eval pulm source History: as above New left upper lobe focal opacity consistent with infection. Elsewhere, the lungs are unremarkable.Unremarkable mediastinal contours and cardiac silhouette.Cervical spine stabilization hardware.Left PICC, tip in left axillary region.

Output: New left upper lobe opacity consistent with pneumonia or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 89 years old.Reason: eval cause of hypoxemia History: ESRD, CHF, hypoxemia Interval placement of a Dobbhoff tube that is looped in the stomach and the tip is directed cranially, above the GE junction. Repositioning is recommended. Interval placement of a right central catheter that terminates at the right atrium. The remaining support devices are unchanged in position.Improved aeration of the upper lobes with residual nonspecific basilar opacities. Left greater than right pleural effusions are stable.

Output: Repositioning of Dobbhoff tube is recommended.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Struck by car left anterolateral aspect around ribs 9-10. Point tenderness. Left lower lobe pulmonary opacities consistent with pulmonary contusion in the context of known recent trauma. Similar faint opacity seen at the right lung base. Chronic blunting of the costophrenic angles, no visible pleural fluid. No pneumothorax or pneumomediastinum. No obvious displaced rib fractures are appreciated however nondisplaced acute rib fractures may not be visible and cannot be excluded by this technique.

Output: Faint basal opacities, left greater than right, most consistent with pulmonary contusion. No visible of rib fractures however correlate with dedicated rib series if clinically suspected. No pneumothorax or signs of hemothorax are appreciated. The patient should return for additional imaging if symptoms worsen.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Cough postop CABG. Improved lung volumes, high normal, consistent with COPD/emphysema given flattening of the diaphragm. Normal heart size. Faint left lower lobe groundglass opacity nonspecific and could be the result of aspiration pneumonitis or less likely edema.No pneumothorax . Surgical clips right upper quadrant. Small pleural effusions.

Output: Small pleural effusions. Faint left lower lobe groundglass opacity nonspecific and could be the result of aspiration pneumonitis or less likely edema.


Instruction: Generate impression based on medical findings.

Input: Female, 33 years old.Concern for volume overload, shortness of breath Large lung volumes without evidence of pulmonary edema or pleural effusion. The heart size is within limits of normal.

Output: No acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: TLC placement History: TLC placement Swan-Ganz catheter has been removed. Right jugular catheter tip at RA/SVC junction. No evidence of pneumothorax. Interval extubation and removal of nasogastric tube. Other findings stable in short interval.

Output: Right jugular catheter tip at RA/SVC junction.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: ett check History: intubated Interval progression of interstitial and alveolar opacities seen bilaterally. Findings likely representing a RDS. No pneumothorax or other interval change.

Output: Interval progression of interstitial and alveolar opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: 61 y/o male with right tonsilar cancer pt with chest tube History: pneumothorax Left apical chest tube remains in place. Port catheter again noted. No significant pneumothorax. Diffuse left hemithorax pleural-parenchymal opacity, mostly likely representing atelectasis again noted. Abrupt termination of the left mainstem bronchus. No substantial change in right basilar pleural parenchymal opacity. Right-sided subcutaneous emphysema again noted. Dilated loops of bowel again noted within the upper abdomen. Consider correlation with dedicated abdominal radiograph.

Output: Near complete atelectasis of the left lung again noted.No significant pneumothorax.No substantial change in right basilar pleural parenchymal opacity.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: chest pain, mid sternal History: chest pain Support devices including left ventricular assist device are unchanged in position.Severe cardiomegaly, stable. Lower zone reticular opacities appear chronic. Small bilateral pleural effusions. No pneumothorax.

Output: Stable cardiomegaly and small bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: sob History: as above Venous catheter tip in upper SVC.Lungs hypoinflated with no focal opacity to suggest pneumonia. No evidence of significant pulmonary edema.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: evaluate cause of hypoxia History: slighty more hypoxic, chest pain. Has known PE and likely lung cancer. Left hemithorax volume loss with airspace opacity suggestive of infection or aspiration, worsening over the last several days.Right lung unremarkable.Heart is slightly large.

Output: Increasing left lung opacity with volume loss suggestive of infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Diffuse interval increase in patchy opacities greater on the right and left lung base suggesting edema with cardiomegaly and small to moderate effusions. Suspected flash pulmonary edema, however infection cannot entirely be excluded despite the short time interval.Interval removal of the right jugular catheter without apparent additional complication

Output: Suspected flash pulmonary edema and right jugular catheter removed


Instruction: Generate impression based on medical findings.

Input: Atrial fibrillation Interval removal of left chest tube without recurrent pneumothorax. Underlying cardiopulmonary appearance however is otherwise similar with basilar atelectasis greater on the left with mild nonspecific cardiomegaly.ETT and right jugular sheath removed

Output: ETT and left chest tubes removed


Instruction: Generate impression based on medical findings.

Input: 65-year-old male 6 years status post lower lobectomy and adjacent chemotherapy for stage Ib non-small cell lung cancer. Annual surveillance. Please compare with previous. CHEST:LUNGS AND PLEURA: Scattered calcified granulomata bilaterally. No suspicious nodules, masses, or pleural effusion.Mild scarring from left lower lobe resection.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Moderate calcifications of the right coronary, left circumflex, and LAD arteries.CHEST WALL: T11 vertebral body bone island, unchanged since March 2006. 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: Bilateral renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease of the aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: No evidence of recurrent or metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Metastatic colorectal cancer. Evaluate response to chemotherapy. CHEST:LUNGS AND PLEURA: Linear atelectasis in the left upper lobe.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted multiple hypodense lesions in both lobes of the liver. Largest lesion is near the dome and measures 6.2 x 4 cm on image number 61/240. These lesions are suspicious for metastatic disease. However some of the lesions are too small to accurately characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Atherosclerotic disease involving a long segment of SMA with a long segment atherosclerotic plaque versus non-occlusive thrombus.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: 2.7 x 1.8 cm adenopathy adjacent to the sigmoid colon on image number 174/240. Additional smaller adenopathy is also present along the rectum and sigmoid colon.BOWEL, MESENTERY: Wall of the distal rectum is thickened likely representing patient's known rectal cancer.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Pelvic adenopathy. Liver metastases. Rectal wall thickening likely representing patient's known rectal cancer.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: s/p MAZE History: s/p MAZE Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 65-year-old male with metastatic renal cell carcinoma CHEST:LUNGS AND PLEURA: numerous bilateral lung nodules are again noted and there slightly more prominent compared to previous CT.MEDIASTINUM AND HILA: Cluster of small mediastinal lymph nodes are unchanged.CHEST WALL: Bone metastases in the ribs and vertebral bodies are unchanged. Compression fracture of T8 vertebral body secondary to metastatic disease has slightly progressed.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Irregular shaped lesion in the lower pole of the left kidney is unchanged. Again no old this enhancement is noted within this lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Several sclerotic foci in the vertebral bodies consistent with metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic foci in the pelvic bones and sacrum consistent with metastatic disease.OTHER: Fat-containing left-sided inguinal hernia is unchanged.

Output: Slight interval increase in the size of the lung metastases.All metastases are grossly unchanged except for minimal progression of the compression deformity of T8 vertebral body.Left renal lesion is unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: swan placement History: none Swan-Ganz catheter tip terminates in the right interlobar pulmonary artery.Small bilateral effusions and associated atelectasis/edema, appearing similar to the prior examination. Moderate cardiomegaly unchanged. There is no pneumothorax.

Output: Basilar pulmonary edema/atelectasis and effusions similar to prior.


Instruction: Generate impression based on medical findings.

Input: Fever Persistent mild to moderate right pleural effusion and underlying atelectasis. Lungs are otherwise clearUnchanged right jugular single port. Left PICC line terminates in the innominate near the SVC junctionCardiac and mediastinal contours are within limits.

Output: Well-positioned left PICC line and small/moderate right effusion


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: eval for chest pain History: new onset chest pain No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 72 year-old female with metastatic melanoma CHEST:LUNGS AND PLEURA: Left lower lobe nodule measures 9 x 9 mm image number 87, series number 5, unchanged. Multiple new nodules are seen predominantly in the right lung. A reference new nodule in the right lower lobe measures 8 x 6 mm on image number 59, series number 5.MEDIASTINUM AND HILA: Right hilar adenopathy measures 10 x 10 mm. Pretracheal adenopathy measures 13 x 9 mm image number 31, series number 3. Previously floes measuring 11 by 8mm subcarinal adenopathy is also slightly enlarged.Thyroid nodules unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic lesion in the neck of the pancreas is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant ileostomy is unchanged. Significant interval progression of peritoneal carcinomatosis no involving the entire abdomen. New moderate amount of ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Peritoneal metastatic disease invades the ovaries and uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse peritoneal carcinomatosisBONES, SOFT TISSUES: No significant abnormality noted.OTHER: Patient's known presacral mass has significantly increased in size and now measures 11.1 x 5.6 cm image no 193, series number 3.New bilateral inguinal enhancing masses. Reference left inguinal mass measures 2.4 x 2.3 cm in image number 186, series number 3.

Output: Interval progression of disease with appearance of new lung nodules. Slight increase in the size of the mediastinal adenopathy and significant increase in the peritoneal carcinomatosis and the size of the pelvic mass.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: s/p RLL wedge for lung nodule History: s/p RLL wedge for lung nodule Right chest tube following surgery with no pneumothorax.Mild basilar opacities are suggestive of atelectasis.

Output: No pneumothorax, right chest tube in place.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: eval ETT, lung fields History: s/p CABG Lines and tubes are unchanged. Low lung volumes with patchy bibasilar opacities and small pleural effusions again noted. Unchanged cardiomegaly. No significant pneumothorax.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: MaleReason for Study: Reason: fever History: as above The cardiomediastinal silhouette is unremarkable.The lungs are clear.Mild blunting of the left costophrenic angle similar to the prior exam.

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


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Fatigue, evaluate for pneumonia. Normal heart size. Tortuous thoracic aorta with mild atherosclerotic calcification. Fullness in the aortopulmonary window region may reflect pulmonary hypertension, though the more peripheral aspects of the central arteries appear to be of normal caliber. No pneumothorax or pleural fluid. Paratracheal opacity may reflect vascular ectasia but is nonspecific on the left.

Output: No signs of pneumonia. Fullness in the left paratracheal region and aortopulmonary window of indeterminate etiology. Although these appear smoothly marginated and are favored to represent tortuous or ectatic vasculature, the possibility of lymphadenopathy cannot be excluded. Suggest follow-up PA and lateral chest radiographs for further characterization when feasible.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: s/p PICC placement History: no sx The left PICC terminates within the right atrium. The tracheal, esophageal and gastroesophageal stents are unchanged in position. The right-sided airspace opacity and pleural effusion are not significantly changed from the previous exam.

Output: Minimal change in the right-sided pleural effusion and airspace opacity. The left PICC terminates within the right atrium, consider retracting.


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Abscess of liver status post failed chest tube placement assess for pneumothorax. No pneumothorax.Right lower thorax pigtail catheter changed in orientation.New subcutaneous emphysema right chest wall and a right upper quadrant surgical drain.Loculated pleural fluid on the right similar in volume.Extensive consolidation in the right lung appears worse.Lung volumes remain low.Atelectasis in the right middle lobe medial segment.

Output: There appears to have been interval manipulation of the right pigtail catheter with subcutaneous emphysema, but no pneumothorax. Right pleural fluid collection similar in volume, but the nonspecific consolidation may be worse.


Instruction: Generate impression based on medical findings.

Input: Kidney donor No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Age: 54 yearsGender: MaleReason for Study: Reason: eval for edema/infiltrate History: chest pain The cardiomediastinal silhouette is unremarkable.Left pleural effusion and underlying atelectasis similar appearance to the outside CT.The right lung is clear.No right pleural effusion.

Output: Moderate sized left pleural effusion with underlying atelectasis/consolidation similar to the prior outside CT.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: assess lines History: hypotensive on inotropes Swan-Ganz catheter tip in the right main pulmonary artery.ICD lead unchanged.Cardiomegaly with basilar opacities compatible with infarcts secondary to recently documented pulmonary embolism.

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


Instruction: Generate impression based on medical findings.

Input: Stroke Decreased lung volumes with COPD changes and moderate nonspecific cardiomegaly. Small right effusion cannot be excluded.

Output: Mild to moderate cardiomegaly without definite superimposed changes of edema and/or failure. Consider serial imaging since small right effusion cannot be excluded


Instruction: Generate impression based on medical findings.

Input: 76 years, Female. Reason: Concern of Ileus vs large stool burden History: abdominal pain, distention Multiple dilated gas-filled loops of small bowel seen throughout the abdomen. Average stool burden. No evidence of free air on the left lateral decubitus position. Vascular stent and surgical clips seen overlying the mid abdomen and pelvis. Bilateral hip prostheses are visualized.Please see same-day chest x-ray for chest results.

Output: Multiple dilated gas-filled loops of small bowel seen throughout the abdomen but no specific evidence of obstruction. Average stool burden


Instruction: Generate impression based on medical findings.

Input: Male, 81 years old.Check for pneumothorax post left upper lobe biopsy for malignant neoplasm. No pneumothorax.Hazy interstitial opacity in the left lung with a focal nodule in the upper lobe unchanged. Mild interstitial changes are noted on the right.. Small volume of pleural fluid on the left. Left hilar mass or lymphadenopathy.

Output: No pneumothorax. Left hilar mass/lymphadenopathy and a peripheral left upper lobe nodule noted.


Instruction: Generate impression based on medical findings.

Input: 57 year-old female with metastatic breast cancer CHEST:LUNGS AND PLEURA: Multiple scattered areas of honeycombing and fibrotic changes consistent with patient's known history of scleroderma. Bilateral lung bases demonstrate extensive honeycombing. No evidence of effusion.MEDIASTINUM AND HILA: Reference is right hilar lymph node is unchanged measuring 11 x 12 mm on image number 43, series number 3.CHEST WALL: Right axillary lymph node unchanged.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: Extensive diffuse bony metastases in the visualized bones.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple large fibroids arising from the uterus. A separate that the low density lesion measuring 4 x 4 cm in the right adnexa may represent another fibroid, however, an ovarian origin mass cannot be excluded. This appearance is unchanged from previous CT.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: Bilateral extensive honeycombing of the lungs, unchanged. Right hilar adenopathy, diffuse bony metastases are unchanged.Leiomyomatous uterus is unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 34 years old. Support devices are unchanged in position.Cardiomegaly stable. No interval edema or pneumothorax.

Output: Stable cardiomegaly without edema.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for new effusion vs infiltrate History: SOB, cough Markedly enlarged cardiac silhouette which may be due to cardiomegaly or pericardial effusion, not significantly changed.Increased upper zone blood flow but no sign of pulmonary edema or pleural effusions.

Output: Cardiomegaly with no acute change.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: Evaluate for infection History: NMO flare No acute cardiopulmonary abnormality.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Bronchial valve removal and placement check for pneumothorax Multiple bronchial valves project of the left hilar region without evidence of interval change complication. Diffuse emphysematous changes with marked bulla in both bases greater on the right appear similar. Small effusions

Output: Unchanged left bronchial valves


Instruction: Generate impression based on medical findings.

Input: Reason: S/P LVAD. eval for VAD position History: post-op eval Interval removal of a left jugular catheter. Right jugular catheter, ICD leads and LVAD unchanged. Marked cardiomegaly with moderate pleural effusions and basilar atelectasis.

Output: Cardiomegaly with pleural effusions and atelectasis, without significant change.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields, hx dvt and heart tx History: dvt Normal cardiac and mediastinal contours with evidence of previous median sternotomy.Mild scarring at the right base and no acute findings.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: eval for acute cardiopulmonary abnormality History: syncope, q waves on ekg Cardiomediastinal silhouette and vasculature are normal. Lungs are clear of airspace and interstitial opacities. No pneumothorax. No pleural effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: icu History: Malignant neoplasm of the esophagus. Tracheostomy tube and venous catheter unchanged.Distended gastric interposition extending to the right of the mediastinum.Nonspecific diffuse pulmonary opacities suggestive of edema and probable small pleural effusions without significant change.No new findings.

Output: Diffuse pulmonary opacities suggestive of edema/ARDS with no significant change.


Instruction: Generate impression based on medical findings.

Input: Reason: hx of bladder cancer evaluate for metastatic disease History: see above Normal cardiac and mediastinal silhouette with a mitral valve ring in place.Intact sternotomy sutures.No sign of metastases or other significant pulmonary abnormalities.

Output: No sign of metastases or other acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 18 years old.Reason: intubated History: as above Patchy basilar airspace opacities unchanged consistent with multifocal pneumonia.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: Unchanged multifocal pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Reason: chest pain evaluation History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 38 years old.Reason: 37m HISTORY OF TESTIS CANCER, ASSESS FOR METS History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No sign of metastases.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: new cough, new wbc, worse ams, eval for pna History: see above Moderate to severe cardiomegaly.Equivocal pulmonary edema and left mid lung atelectasis.The lungs are better inflated than 5/26/2015. No specific evidence of infection.

Output: Cardiomegaly with minimal edema, but no specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old. Vomiting without nausea No focal pulmonary opacity, pleural effusion or pneumoperitoneum. Mild cardiomegaly. Air-fluid level in the stomach. Postsurgical changes of the right colon. Surgical clips are noted in the pelvis. Nonobstructive bowel gas pattern. No free air.

Output: Distended stomach with air-fluid level. Otherwise nonobstructive bowel gas pattern.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: CP History: CP Calcified granuloma the right lung base. Lungs otherwise clear. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 41 year old female with adenoid cystic carcinoma of the parotid. Restaging scan LUNGS AND PLEURA: Again identified is a stable small micro-nodule within the right upper lobe. No new pulmonary nodules or pleural effusion can be identified.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: There is no evidence of metastatic disease. No significant interval change identified in comparison to the previous exams dated 8/4/08 and 1/18/08


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Cough and fever question lung infiltrate Airspace opacity and bronchial wall thickening in the right middle and lower lobes consistent with bronchitis and suspicious for pneumonia. Small right pleural fluid collection.Normal heart size. There may be mild right hilar lymph node enlargement.

Output: Bronchitis and faint opacities suspicious for pneumonia in the right lung. Small right pleural effusion. In an adult patient, six-week follow-up PA and lateral radiographs are suggested to assess for resolution.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Elevated white blood count status post "PEG pla". Nasogastric tube in the stomach with tip at the gastric fundus. Surgical clips near the GE junction, but no gastrostomy tube retention device is appreciated.Volume loss in the right upper lobe. Mild diffuse interstitial opacity suggestive of edema. Patchy opacity in the upper lobes most likely reflects dependent atelectasis.

Output: Mild edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: et tube placement History: et tube ET tube tip approximately 2 cm above the carina.Small lung volumes with nonspecific perihilar opacity suggestive of aspirated secretions.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 20 yearsGender: FemaleReason for Study: Reason: r/o PNA History: cough The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.VP shunt tubing overlying the right hemithorax.

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


Instruction: Generate impression based on medical findings.

Input: Reason: post line History: post line Cardiomegaly with right basilar opacity compatible with atelectasis and a small effusion.No evidence of pneumothorax or a venous catheter in the chest.

Output: Basilar atelectasis and small effusion, decreased compared to previous.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: IABP monitoring History: IABP Intra-aortic balloon pump terminates 1.1 cm from the top the aortic arch. Other iatrogenic devices, unchanged. Mild pulmonary edema, increased from last study. No large pleural effusion or pneumothorax. Unchanged cardiomegaly.

Output: Slight increase in pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.ADHF question pulmonary edema. Mitral disease. Unchanged cardiomegaly. Left subclavian AICD/pacemaker unchanged in position.Mild vascular redistribution but no specific signs pulmonary edema. Mild blunting of the posterior costophrenic angles may be due to small pleural fluid collections, unchanged.

Output: No specific signs of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 84 years old.Reason: worsening pulmonary edema, worsening pleural effusion, worsening LUL opacity History: SOB Unchanged pulmonary opacities consistent with edema and infection particularly on the left.Stable pleural effusions.

Output: Unchanged pulmonary opacities consistent with edema and infection. Unchanged pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: patient with IABP, check placement History: none Moderate cardiomegaly without edema.Left subclavian ICD, leads unchanged in position.IABP catheter proximal marker projects over the aortic arch, unchanged.Right PICC, tip in axillary region.

Output: Cardiomegaly. Unchanged support devices.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Patient presented with chest pain, evaluate for dissection or mediastinal pathology. Right jugular chest port is unchanged. Lung volumes are slightly expanded. Heart size is slightly enlarged. Aorta is tortuous, without radiographic evidence of dissection. Mediastinal surgical clips and sternotomy wires are noted. Mild basal atelectasis is unchanged.

Output: Mild cardiomegaly and tortuous aorta without radiographic evidence of dissection.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: R sided chest pain History: R sided chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Ischemic cardiomyopathy, check for pleural effusions and atelectasis Persistent mild to moderate basilar streaky densities most suggestive of atelectasis with small effusions. No discrete new airspace abnormality superimposed upon mild emphysemaLVAD and left subclavian ICD are unchanged. Mild to moderate cardiomegaly. Midline sternotomy

Output: Basilar atelectasis and pleural small effusions unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 19 years old.Reason: hx of Spontaneous pneumothorax of the Right Lung History: chest discomfort Recurrent right pneumothorax, 2.4 cm separation between pleural surfaces.

Output: Recurrent right pneumothorax. This was discussed with Dr. Sean Stoy 8/23/2016 at 1:50 PM.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields, edema and effusions on previous CXR's, intubated History: crackles on auscultation ET tube tip approximately 3 cm above the carina.Chest tubes unchanged and interval removal of the Swan-Ganz catheter and echo cannula.Cardiomegaly with diffuse pulmonary opacity compatible with edema with small pleural effusions.

Output: Pulmonary edema, slightly improved over the past 2 days, and small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 45 years old.Chest pain. Question of pneumonia or pneumothorax. No focal opacity, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormality.