Instruction: Generate impression based on medical findings.

Input: Reason: history of dilated ascending ao History: hypertension, dilated ao CHEST:LUNGS AND PLEURA: Opacities in the left apex likely represent scarring.MEDIASTINUM AND HILA: No lymphadenopathy. The heart size is normal without pericardial effusion. Ascending aorta measures 4.3 cm in diameter. The aortic arch measures 3.3 cm in diameter. The descending aorta measures 2.4 x 2.3 cm.CHEST WALL: No significant abnormality noted

Output: Ascending aortic ectasia measuring up to 4.3 cm.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: assess placement of PA catheter History: PA catheter in place Moderate to severe cardiomegaly.Small lung volumes without edema or pneumonia.Left jugular Swan-Ganz catheter, tip in right main pulmonary artery.Left subclavian ICD, leads unchanged in position.

Output: Moderate to severe cardiomegaly without edema. Unchanged support devices.


Instruction: Generate impression based on medical findings.

Input: Age: 71 yearsGender: MaleReason for Study: Reason: Trach History: Trach Support devices unchanged.Stable cardiac enlargement.Pulmonary opacities, basilar atelectasis, and pleural effusions similar in appearance to the prior exam.No new opacities identified.

Output: Support devices unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 25 years old.Reason: Eval for effusion and atelectasis History: S/P AVR Small lung volumes with small pleural effusions and left basilar atelectasis, unchanged.Mild to moderate cardiomegaly status post median sternotomy.

Output: No change in small pleural effusions and left basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: 52 year-old female with metastatic melanoma CHEST:LUNGS AND PLEURA: Chronic volume loss in the left lower lobe is again noted. Index left upper lobe nodule is unchanged measuring 7 mm in diameter image number 46 on series number 6. Other, bilateral, multiple subcentimeter lung nodules are also unchanged.Left lower lobe conglomerate of nodules/atelectasis also unchanged measuring 2.3 x 2.3 cm on image number 54, series number 6. Previously it was measuring 2.4 x 2.5 cm on image number 50, series number 5. MEDIASTINUM AND HILA: Index precarinal lymph node is unchanged measuring 1.4 by 0.7 cm in image number 30, series number 4. Other mediastinal lymph nodes are also unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple left renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change in the size of the parenchymal pulmonary lesions and mediastinal adenopathy


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Hypotension evaluate for pneumothorax versus hyperinflation. Severe emphysema. No pneumothorax. Leftward shift of the anterior junction line.The large bulla in the right lung compressing adjacent parenchyma is unchanged.Blunting of the costophrenic angles unchanged.Dilated large bowel in the upper abdomen consistent with previous diagnosis of ileus.

Output: No pneumothorax. Severe hyperinflation of right lower lobe


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.History of aortic valve replacement. Aortic bioprosthetic valve, mediastinal surgical clips, and sternotomy hardware. Stable cardiomediastinal silhouette.Previously seen pleural effusions and basilar opacities have resolved.Moderate compression deformity of T11, unchanged.

Output: Resolution of effusions and basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: evaluate for pneumonia History: difficulty breathing, COPD No pleural effusion or pneumothorax. Pulmonary nodule visualized on lateral film in the right upper lobe, better described on same-day CT. Large lung volumes and flattened hemidiaphragms. No other focal areas of opacity. The cardiomediastinal silhouette is within normal limits.

Output: Right upper lobe nodule is concerning for primary malignancy and is better characterized on same-day CT. Large lung volumes and flattened hemidiaphragms consistent with COPD.


Instruction: Generate impression based on medical findings.

Input: 69-year-old male with history metastatic prostate cancer. Assess for disease progression. Vague bony aches/pains. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules bilaterally, grossly unchanged in size and number. Reference right middle lobe lesion (series 5, image 40) measures 2.1 x 2.2 cm (stable).Stable right apical scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Marked mitral annular and coronary artery calcifications.Right perihilar soft tissue mass containing punctate calcification (series 3, image 40) measures 2.6 x 2.4 cm, which is unchanged when accounting for differences in technique; using similar measurement techniques this lesion previously measured 2.6 x 2.4 cm as well.CHEST WALL: No significant abnormality noted. ABDOMEN: LIVER, BILIARY TRACT: Diffuse fatty infiltration.SPLEEN: No significant abnormality noted.PANCREAS: Focal hypoattenuating lesion in the pancreatic head again measures 1.2 x 1.2 cm (series 3, image 106).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small low-density lesions in the kidneys remain too small to characterize but are grossly unchanged in size. Nonobstructing renal stones again seen bilaterally.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the descending aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy. Penile prosthesis with reservoir in left anterior abdomen reidentified.BLADDER: No significant abnormality noted.LYMPH NODES: Reference right external iliac node (series 3, image 165) measures 0.8 x 0.6 cm (stable).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable sclerotic changes in the right sacrum and pubic symphysis.

Output: 1. Stable pulmonary and osseous metastases. No new sites of disease identified.2. Low-density lesion in the pancreatic head is also unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.History of end-stage renal disease with +PPD, evaluate for tuberculosis. Unremarkable cardiomediastinal silhouette.No focal pulmonary opacities, pneumothorax, or pleural effusions. Stable bilateral apical pleural thickening.No specific evidence of active TB or other mycobacterial disease.

Output: No significant cardiopulmonary abnormality by radiography


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: cough, known aspiration History: cough, known aspiration Resolution of prior pulmonary opacities.No specific evidence of infection or edema.Unremarkable mediastinal contours and cardiac silhouette.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: 30M s/p OLT now with severe back pain upon inspiration. History: Back pain Right subclavian and left jugular venous catheters unchanged.Small lung volumes with bilateral pleural effusions, larger on the right, with underlying opacity compatible with consolidation and atelectasis.No new findings.

Output: Pleural effusions, atelectasis and nonspecific consolidation with no acute change.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: evaluate for pulmonary edema and status of recent reported CAP vs. Aspiration PNA at OSH History: recent report of PNA w hypoxemia and altered mental status c/f aspiration Right upper extremity PICC tip in the axillary vein. Surgical clips in the right upper quadrant again seen.Cardiac size is upper limits of normal.Stable elevation of the right hemidiaphragm. Likely right upper lobe subsegmental atelectasis. Pleural effusions. Mild perihilar and basilar opacities compatible with edema.

Output: CHF versus aspiration or infection.


Instruction: Generate impression based on medical findings.

Input: 85 years old Female. Reason: s/p attempted BIJ central line placement History: see above. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins. There is diffuse bilateral interstitial edema. The cardiac pacemaker/defibrillator electrodes are stable in position. The right IJ catheter has been removed.

Output: The above findings are consistent with congestive heart failure, unchanged as compared with prior study.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o infection, hx: stem cell transplant History: SOB, coarse LS Unremarkable cardiac and mediastinal silhouette. Perihilar bronchial thickening compatible with bronchitis, but no sign of pneumonia or pleural effusions. Small calcified granuloma in the right mid lung compatible with previous infection.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: stent placement History: cough A stent has been placed in the right interlobar bronchus, which remains quite narrow.Reticulonodular opacity throughout the right lung has worsened, consistent with asymmetric edema possibly from central lymphatic and venous obstruction.Mild atelectasis left base.No significant pneumothorax.ET tube tip approximately 4 cm above the carina.

Output: Right interlobar bronchus stent placement, with increasing right lung opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: check placement of central PICC line History: picc Right upper extremity PICC tip in the cavoatrial junction. Tortuous aorta noted. Moderate cardiomegaly given AP view. Bibasilar atelectasis or scar.

Output: Right upper extremity PICC tip in the cavoatrial junction.


Instruction: Generate impression based on medical findings.

Input: Reason: worsening respiratory failure History: hypoxia ET tube tip approximately 3 cm above the carina.Small lung volumes with diffuse airspace and interstitial opacity, increased compared to the previous exam.A more recent radiograph has been interpreted.

Output: Increasing pulmonary opacity compatible with the clinical diagnosis of ARDS, possibly with superimposed edema.


Instruction: Generate impression based on medical findings.

Input: Age: 79 yearsGender: FemaleReason for Study: Reason: respiratory distress History: SOB, bibasilar crackles Stable cardiac enlargement.Interval improvement in the bilateral pleural effusions and basilar atelectasis.No new focal areas of consolidation.

Output: Cardiomegaly with interval improvement in the basilar atelectasis and small effusions. No specific evidence of acute infection


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: being treated for disseminated tuberculosis x2 months and now no cough History: fatigue, SOB Small left pleural effusion, unchanged.Right lung unremarkable.Heart size normal.

Output: Unchanged left pleural effusion. No new findings.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p centrimag BiVADs, eval ETT, r/o effusions History: as above Cardiopulmonary monitoring and support devices, unchanged.Cardiomegaly with bilateral airspace opacity compatible with edema, atelectasis and pleural effusions.Edema has slightly improved since the previous day.

Output: Resolving pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Reason: 22 y/o with head/neck CA; please eval for aspiration or pna History: Fever Port catheter terminates near the cavoatrial junction. No focal lung consolidation or evidence of overt left-sided heart failure. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 80-year-old female with new oxygen requirement. Evaluate for pulmonary source of infection. Left upper extremity PICC tip in the left brachiocephalic vein. Bibasilar scarring/atelectasis. Dense posterior costophrenic angles raising the question of small pleural effusions. Normal cardiomediastinal silhouette.

Output: Possible small pleural effusions. No definite evidence of pulmonary edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: 52-year-old female with breast cancer. Restaging CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules largest measuring 4-mm image number 44, series number 4 are unchanged. No new nodules.MEDIASTINUM AND HILA: Previously measured right hilar lymph node measures 12 by 15-mm image number 30, series number 3, not significantly changed.CHEST WALL: Postsurgical changes in the right axilla. Right axillary adenopathy is unchanged. Index lesion measures 12 x 9 mm image number 8 of series number 3. Previously fuzz measuring 11 x 10 mm image number 14, series number 3. Small fracture in the lymph nodes are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Diffuse, confluent hypoattenuating lesions consistent with known metastatic disease and giving the liver pseudocirrhosis appearance is unchanged. Index lesion in the right lobe measures 16 x 14 mm image number 96, series number 3 is unchanged.Mild soft tissue infiltration of the porta hepatis, unchanged.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: Stable retroperitoneal lymphadenopathy. Index left para-aortic lymph node measures 9 x 6 noted on image number 116, series number 3.BOWEL, MESENTERY: Stable mesenteric adenopathy. Reference node measures 15 by 8mm image number 119, series number 3.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of ascites, unchanged.PELVIS:UTERUS, ADNEXA: Not well-visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Bidirectional Glenn for AV canal.VIEW: Chest AP (one view) 08/31/16, 0430 Endotracheal tube tip is above carina. A chest tube is present in each hemithorax. Feeding tube tip is distal to mid body of stomach and not included on image. Gauze sponges are noted over the left upper chest. Mediastinal and neck surgical clips are again seen. Left internal mammary artery catheter remains in place. There is a right atrial line. Epicardial pacer leads and pacemaker device are seen. Lower extremity central line tip is in the intrahepatic IVC. A gastrostomy tube is present.Cardiothymic silhouette is mildly enlarged and unchanged. Small to moderate left pleural effusion is seen. Hazy lung opacities are slightly diminished. No pneumothorax is seen.

Output: Left pleural effusion is a new finding.


Instruction: Generate impression based on medical findings.

Input: 50-year-old female with cough. Evaluate for pneumonia. Cardiomediastinal silhouette is normal. No pulmonary opacities, pleural effusions, or pneumothorax.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: intubated History: intubated Support devices unchanged.Cardiac enlargement with perihilar/basilar opacities compatible with edema.Left retrocardiac consolidation/atelectasis and small effusion similar to the prior exam.

Output: Support devices unchanged with ET tube tip 6 centimeters above the carina. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: eval for pulm edema, pna History: desaturations Small lung volumes with an increase in interstitial opacities possibly edema versus underinflation artifact.No specific evidence of infection.Moderate cardiomegaly.Left subclavian PICC line tip at SVC/RA junction level.Unchanged right chest wall mass involving the lateral aspect of the right third rib.

Output: Edema versus underinflation artifact. No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Reason: pna/ACS History: pna/ACS? Unremarkable cardiac and mediastinal silhouette. Blunting of the right costophrenic angle consistent with scarring, unchanged.Port-A-Cath with its tip in the right atrium.No specific evidence of pneumonia or other acute change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Malignant neoplasm of ovary. NG tube placement. SBO. Right jugular chest port tip at the SVC. Enteric tube terminates in the gastric body with sidehole just below the GE junction. Small loculated left pleural fluid collection with pleural thickening and associated rounded atelectasis at the lung base about the same. Probable air-filled hiatal hernia. No signs of pulmonary edema.

Output: NGT tip projects over the gastric body with sidehole just beyond the GE junction. No acute change in complex left pleural fluid suspicious for malignant effusion. Please note that empyema could have a similar appearance.


Instruction: Generate impression based on medical findings.

Input: 61 years, Female. Reason: NJ tube placement History: None There are bilateral lower lobe interstitial airspace opacities, unchanged since chest radiograph August 16, 2015. Enteric tube is identified with the tip coursing through the gastrojejunal anastomosis and probably terminating within the jejunum. Multiple surgical clips overlie the abdomen. An IVC filter is in place. There are nondilated loops of bowel. The lower abdomen is excluded from the field-of-view.

Output: 1.Enteric tube with tip passing through the gastrojejunal anastomosis and probably terminating within the jejunum.2.No evidence of bowel injection.


Instruction: Generate impression based on medical findings.

Input: 53-year-old female with history of breast cancer and progressive hypoxia. Confirm no PE (prior study 4/25/2011). Evaluate for lymphangitic spread (known pulmonary metastases). CHEST:PULMONARY VASCULATURE: No PE. Study is diagnostic to the subsegmental level.LUNGS AND PLEURA: Extensive pulmonary metastases are reidentified, many of which continue to increase in size since prior exam. Reference left lower lobe nodule (series 7, image 94) measures 18 x 13 mm, previously measuring 12 x 14 mm. Right lower lobe nodule (series 7, image 92) measures 18 x 16 mm, previously measuring 15 x 13 mm. Areas of ground glass and septal thickening likely represent lymphangitic spread of tumor.Note is also made of scattered, indistinct micronodules in a vascular distribution that may be seen in patients with tumor microemboli.Mild right pleural thickening near the base.MEDIASTINUM AND HILA: Extensive mediastinal, bilateral hilar, and cardiophrenic lymph nodes are also again seen. Reference subcarinal lymphadenopathy (series 5, image 106) measures 42 x 21 mm, previously measuring 43 x 22 mm.Interval increase in right heart chamber size with straightening of the intraventricular septum, suggesting increase in right heart pressures.CHEST WALL: Previously seen left breast mass is only partially visualized on this study (series 5, image 116) and is not accurately measurable. Lytic lesion with cortical destruction of the inferior endplate of the T12 vertebral body (series 80479, sagittal image 50) appears unchanged.UPPER ABDOMEN: Multiple hepatic metastases are again partially visualized with interval increase in the size of many of the lesions. Reference segment 8 lesion (series 5, image 198) measures 47 x 38 mm, previously measuring 35 x 32 mm.Bilateral adrenal gland thickening, unchanged.

Output: 1. No large PE.2. Scattered, indistinct micronodules in a vascular distribution along with interval chamber enlargement of the right heart raise the possibility of tumor microemboli.2. Interval progression of pulmonary and hepatic metastases.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Shortness of breath. ET tube placement. Hyperexpanded lucent lungs suggesting emphysema. Somewhat coarsened bibasilar interstitial opacities again noted which may reflect edema or chronic fibrosis similar to previous. Thin-walled air cyst may be present at the left lung base and more optimally visualized on the current study. An additional more focal left retrocardiac airspace opacity is new and may reflect aspiration or infection.ET tube is 6 cm of the carina.NG tube has been removed and now appears in the right lower lobe bronchus.

Output: NG tube now overlies the right lower lobe bronchus. New retrocardiac consolidation suspicious for aspiration/infection. The clinical service was notified of these findings at 4:00 AM.


Instruction: Generate impression based on medical findings.

Input: Age: 68 yearsGender: FemaleReason for Study: Reason: ETT placement History: ETT ET tube is in place with its tip 2 cm above the carina.Right PICC line with its tip in the SVC.Right pleural drainage catheter unchanged.Right pleural effusion and perihilar/basilar opacities compatible with edema and atelectasis similar in appearance to the prior exam.Stable cardiac enlargement

Output: Interval intubation with ET tube tip in acceptable position. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Hypoxia Extensive postsurgical changes with chest distortion of the right upper hemithorax appear unchanged. Reticular the lungs demonstrate mild increased interstitial changes bilaterally concerning for early edema without definite additional superimposed focal findings or effusions in this limited semiupright portable chest.The cardiac and mediastinal contours are grossly within limits given distortion and prior imaging. Spinal stimulator unchanged, tip projects up to the level of T5.

Output: Extensive postsurgical changes with new superimposed findings suggesting early edema however and although less likely, nonspecific infection must also be considered. Serial imaging will be helpful to confirm.


Instruction: Generate impression based on medical findings.

Input: Age: 50 yearsGender: MaleReason for Study: Reason: please verify ET tube position History: s/p ECMO and IABP Support devices unchanged with IABP marker in the proximal descending aorta.There are decreased lung volumes with stable cardiac enlargement.Right upper lobe pulmonary opacity increased from the prior exam.Persistent left retrocardiac consolidation/atelectasis.Mild improvement in the right basilar opacity and pleural effusions.

Output: Support devices unchanged with ET tube tip approximately 3 cm above the carina. Multifocal pulmonary opacities may be related to aspiration or infection.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Lungs and pleural spaces are clear. The heart size is normal. Surgical clips in the right upper quadrant suggestive of prior cholecystectomy.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Reason: IABP, swan placement History: as above Right jugular Swan-Ganz catheter tip at the distal right main pulmonary artery level. Left subclavian ICD unchanged. No pneumothorax, visible pleural fluid or focal pulmonary opacities. IABP marker similar in position reflecting over the region of the aortic knob.

Output: Line position stable. No evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Age: 77 yearsGender: FemaleReason for Study: Reason: 76F s/p left VATS History: s/p left VATS Left-sided chest tube has been removed.No evidence of a pneumothorax.Stable cardiomediastinal silhouette with redemonstration of an aortic graft unchanged.No focal areas of consolidation.No pleural effusions.Right shoulder arthroplasty noted.

Output: No acute cardiopulmonary abnormalities are identified. Aortic stent graft unchanged.


Instruction: Generate impression based on medical findings.

Input: Check for pneumothorax No immediate postprocedural complication or interval change in cardiopulmonary appearance given attempted line placement. Subsequent images interpreted

Output: Persistent suspected CHF


Instruction: Generate impression based on medical findings.

Input: 83-year-old male with history of low-grade fever, cough, and sore throat. Evaluate for pneumonia. Cardiomediastinal silhouette is unremarkable. No focal air space opacities, pleural effusions, or pneumothorax.

Output: No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: MaleReason for Study: Reason: gsw History: gsw r upper chest The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 57 year-old female with breast cancer CHEST:LUNGS AND PLEURA: Subcentimeter nodule in the right upper lobe on image number 29, series number 5, is unchanged. No other nodules.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: Bilateral benign-appearing renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Previously described bony lesion, extending into the spinal canal at the level of T5 vertebral body is unchanged. Other sclerotic foci in the bones are also unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: 56-year-old female with tachycardia. History of cancer with new atrial flutter/atrial fibrillation. Evaluate for PE. CHEST:PULMONARY VASCULATURE: No PE. Study is diagnostic to the subsegmental level.LUNGS AND PLEURA: Mild linear scarring in the left upper lobe. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Coronary artery stents and calcifications.CHEST WALL: Right mastectomy. Multiple surgical clips in right axilla. Degenerative changes of the spine. UPPER ABDOMEN: Hypoattenuating lesion near the hepatic dome, measuring approximately 3.5 x 2.7 cm, compatible with known hepatic metastasis seen on prior CT from April 2011.

Output: 1. No PE and no other acute cardiopulmonary abnormality.2. Partially visualized liver metastasis near the hepatic dome.


Instruction: Generate impression based on medical findings.

Input: Reason: Pt intubated on CVVH --> ETT placement check, and RIJ and LIJ line placement check History: Pt intubated on CVVH ET tube and venous catheters unchanged.Diffuse nonspecific airspace and interstitial opacity, not significantly changed from the previous study but slightly improved over the past 2 days.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: sob History: sob Cardiac size is normal.Atherosclerotic changes of the aorta.The lungs are clear.No pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 68-year-old male with metastatic renal cell carcinoma CHEST:LUNGS AND PLEURA: Scattered bilateral metastatic nodules are again seen. Referenced nodule on image number 64, series number 4 is enlarged measuring 15 x 14 mm in the right lower lobe. Number all of the metastatic nodules have also increased in the interval.MEDIASTINUM AND HILA: Reference right retrocrural lymph node measures 15 x 12 minutes on image number 85, series number 4. Other small mediastinal lymph nodes are also unchanged.CHEST WALL: Chest wall metastases on the right measures 14.5 by 10.2 cm, significantly enlarged in size. Axillary adenopathy and other chest will metastases have also increased in size.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal mass measures 3.5 x 3.3-cm image number 96, series number 4, not significantly changed from previous study. Prominent right adrenal gland is unchanged.KIDNEYS, URETERS: Status post right nephrectomy. Interval minimal increase in the size of the posterior mass in the upper pole of the left kidney measuring 15-mm on image number 104, series number 4. Simple appearing cyst in the upper pole and lower pole left kidney are unchanged.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy. Referenced precaval lymph node measures 2.6 x 2 cm image number 132, series number 4. Other lymph nodes are also minimally increased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subtle lytic lesions in the pelvic bones are unchanged. New enhancing soft tissue nodule in the right gluteal region measuring 14 x 12 minutes on image number 160, series number 4.OTHER: minimal left hydrocele.

Output: Interval progression of disease with increase in size and number of lung nodules, chest wall metastases, and size of left renal mass.Retroperitoneal and left adrenal metastatic disease and mediastinal adenopathy are unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old.Nausea emesis and fevers No acute intrathoracic process. Mild small bowel ileus pattern without obstruction or free air

Output: No acute intrathoracic process. Mild small bowel ileus pattern without obstruction or free air


Instruction: Generate impression based on medical findings.

Input: Reason: cough and fever x 6 days with fever that resolved History: increasing cough x 6 days Normal heart size with moderate mediastinal widening compatible with lipomatosis. No sign of pneumonia or other acute disease.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Shortness of breath rule out pneumothorax. No pneumothorax.Postsurgical changes left hemithorax.Left pleural thickening or loculated fluid with a cavity near the apex, the latter is less well visualized which may be due to partial collapse and/or filling in with fluid. Bronchial wall thickening and peribronchial opacities in the lower lung zones increased on the left which could be the result of aspiration or infection.

Output: No pneumothorax. Increasing opacities in the left lung.


Instruction: Generate impression based on medical findings.

Input: 60 year-old male with syncope. Evaluate for pneumonia. Left-sided central venous catheter tip unchanged.No focal airspace opacities. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: r/o acute cardiopulmonary pathology History: HF, concern for syncope Stable ICD leads.Moderate to severe cardiomegaly.Vascular congestion with mild interstitial opacities can represent mild edema.No pneumothorax. No pleural effusion.

Output: Moderate to severe cardiomegaly with mild edema.


Instruction: Generate impression based on medical findings.

Input: Female, 78 years old.Assess for widened mediastinum. Chest pain and abdominal pain. Multichamber cardiomegaly with enlargement of the central pulmonary vasculature, appearing similar to prior portable radiograph of 9/5/2014.No pneumothorax.No focal airspace opacities or visible pleural fluid. Surgical clips project over the left chest wall and the patient appears to be status post left mastectomy. Sternotomy wires. IVC filter partially visualized

Output: Unchanged cardiomediastinal appearance. Please note that plain film technique has a limited sensitivity for detection of vascular pathology. If there is continued clinical concern, CTA is much more sensitive for detection of abnormalities.


Instruction: Generate impression based on medical findings.

Input: 68 years, Female. Reason: eval for distended colon/obstruction History: abd distension Distended small and large bowel loops likely representing ileus pattern. Right pleural drain. Right pleural fluid and basilar opacities, please refer to recent chest radiograph.

Output: Ileus pattern.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Post cardiac surgery day 1. Interval extubation. Other hardware and devices unchanged.Small to moderate right pleural fluid collection. Diffuse pulmonary opacities consistent with edema and atelectasis slightly worse.

Output: Slight worsening of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: FemaleReason for Study: Reason: Chest tube - s/ppleurodesis History: pleural effusion Left Port-A-Cath unchanged.Right-sided chest tube has been removed.No significant pneumothorax.Stable cardiomediastinal silhouette.Small pleural effusions and interstitial opacities, right greater than left similar to the prior exam.

Output: Right-sided chest tube removed without evidence of a pneumothorax. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: 51-year-old male with non-Hodgkin's lymphoma 60 days post stem cell transplant. Restage. CHEST:LUNGS AND PLEURA: Bilateral apical scarring with nodular opacity appearing similar to previously identified lesion on series 5, image 17115.MEDIASTINUM AND HILA: Interval decrease of mediastinal lymph nodes in the paratracheal, precarinal and carinal lymph nodes. Previously identified pretracheal lymph node, S3 Image 45/230, 1.0 x .9cm (previously on series 4, image 39/223, measured 1.9 x 1.6 cm).CHEST WALL: Right port catheter with tip in the distal SVC/right atrium junction.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Significantly decrease in size of enlarged spleen, now measures 17.8cm on coronal image 53/113.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymph nodes are significantly decreased compared to the prior exam - none are pathologic in size. A reference left para-aortic lymph node is barely measurable on S3 Im 122/230, .6 x .4 cm (previously measured 1.2 x 2.0 cm, on series 4, image 117/223).BOWEL, MESENTERY: Mesenteric lymph nodes are also decreased. None are pathologic in size.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Decrease in size of all measurable disease. Decrease in size of spleen. No new sites of disease.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate pulmonary edema History: see above ET tube and venous catheter unchanged.Small lung volumes with bilateral opacity compatible with edema and small effusions.A more recent radiograph has been interpreted.

Output: Pulmonary edema, slightly improved.


Instruction: Generate impression based on medical findings.

Input: 76 old male with dyspnea status post fall. Stable cardiomegaly.Low lung volumes. Bilateral pleural effusions and perihilar haziness with diffuse interstitial opacities. Prominent minor fissure suggestive of fluid accumulation. No pneumothorax.Right-sided 2-lead pacemaker.Scoliosis. No obvious fracture

Output: Bilateral pulmonary opacities compatible with atelectasis or edema. No obvious fracture.


Instruction: Generate impression based on medical findings.

Input: Female, 22 years old.Nausea and vomiting Clear lungs. No pleural effusion or pneumothorax. Normal heart size. No acute bony abnormality.

Output: Normal chest.


Instruction: Generate impression based on medical findings.

Input: Reason: pna History: temp ET tube tip approximately 3 cm above the carina.Catheter tip in the SVC.NG tube tip in the stomach.Partial atelectasis of the left lower lobe with a moderate left pleural effusion, not significantly changed.Mild opacity at the right base suggestive of interstitial edema and a small effusion.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with chest pain, evaluate for aortic dissection. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodules, masses, or pleural effusion. MEDIASTINUM AND HILA: Precarinal and prevascular lymph nodes are seen. Reference node measures 10.7 mm x 12.4 mm on series 3, image 41. There is mild cardiomegaly. There is no evidence of an aortic dissection. The pulmonary trunk is dialated and measures 3.8 cm (series 9, image 57).CHEST WALL: No significant abnormality noted. LUNG BASES: There is opacity in the left lung base, likely representing atelectasis.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: There is a large right renal cyst measuring 5.3 cm x 5 cm (series 3, image 142).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is mild dilatation of the infrarenal aorta with a maximum AP diameter of 3.0 cm (series 9, image 189).PELVIS:LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.

Output: 1. No evidence of an aortic dissection; mild dilatation of the infrarenal aorta, measurements as above 2. Dilatation of the pulmonary trunk suggestive of pulmonary arterial hypertension3. Nonspecific mediastinal adenopathy.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: 51yoM intubated on vent, assess for PNA, ETT History: intubated on vent Cardiomegaly with small lung volumes and persistent left lower lobe consolidation.No obvious edema.ET tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.

Output: Persistent left lower lobe consolidation, infection and the differential but more likely compression atelectasis or aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: l chest mass History: L chest mass Interval removal of right IJ central catheter. Multiple skin staples over the thoracic midline and left axilla again noted. Several drains project over the thorax.Heart size is mildly enlarged, stable. Small bilateral pleural effusions and diffuse opacities favoring edema. No pneumothorax.

Output: No pneumothorax following removal right central catheter.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Cough and chest pain evaluate for pneumonia. Right chest port unchanged in position. Mild cardiomegaly. Vascular redistribution with mild septal thickening. Groundglass opacity in the right lower lobe with bronchial wall thickening. No pleural fluid.

Output: Cardiomegaly with edema-like interstitial abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 75 yearsGender: FemaleReason for Study: Reason: Confirmation of Hickman catheter placement in prep for TPN. Thanks History: none Right IJ venous catheter with its tip in the SVC.Left central venous catheter with its tip in the SVC.There is cardiac enlargement with moderate sized bilateral pleural effusions and underlying basilar atelectasis.

Output: Bilateral central venous catheters in appropriate positions. Moderate-sized bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Status-post CABG. There appears to be interval removal of a IABP. Swan-Ganz catheter is in stable position and in the right main pulmonary artery. A left-sided chest tube and mediastinal chest tube are in stable position. Status-post median sternotomy. Tiny left apical pneumothorax is difficult to resolve due to overlying soft tissue but is likely stable to improved. Developing basilar consolidation as well as atelectasis. Right pleural effusion not significantly changed.

Output: 1. Interval removal of IABP. Swan-Ganz and chest tubes are in stable position.2. Developing areas of consolidation in the lung bases, now suspicious for pneumonia.3. Tiny left apical pneumothorax is difficult to resolve due to overlying soft tissue but is likely stable to improved.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: icu History: icu Open sternotomy with overlying surgical drains.No significant pneumothorax.Unchanged basilar opacities and pleural effusions.Tracheostomy tube tip approximately 5 cm above the carina.A Dobbhoff tube extends below the lower margin of the image.Left PICC, tip in left subclavian.Left subclavian pacemaker, leads unchanged in position.

Output: Unchanged pulmonary opacities. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate pneumothorax History: pneumothorax, chest tube in left lung Persistent moderately large right pneumothorax mainly located anteriorly.Left chest tube extending to the apex with almost complete atelectasis of the left lung.Extensive subcutaneous emphysema on the right.

Output: Persistent right pneumothorax, probably mainly located anteriorly and almost complete atelectasis of the left lung.


Instruction: Generate impression based on medical findings.

Input: 64-year-old male with AML and fevers; evaluate for fungal pneumonia LUNGS AND PLEURA: Mild scarring in the anterior right middle lobe, azygoesophageal recess,and the lingula. Right up lobe micronodule unchanged.MEDIASTINUM AND HILA: Extensive calcification of the aorta and its branches is reidentified. No lymphadenopathy.CHEST WALL: Degenerative changes of the spine are again noted. Right upper extremity central line tip is in the SVC.UPPER ABDOMEN: The liver appears abnormally dense, appearing similar to prior study.

Output: Stable areas of mild fibrosis in the lungs bilaterally. No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 70 yearsGender: MaleReason for Study: Reason: assess IABP position History: s/p IABP Left IJ Swan-Ganz with its tip in the pulmonary artery.A BB marker in the proximal descending aorta.Decreased lung volumes with perihilar/basilar opacities compatible with edema and atelectasis.No new pulmonary opacities noted.

Output: Support devices unchanged with a BB-marker in the proximal descending aorta and Swan-Ganz catheter with its tip in the pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: Elderly woman with COPD and planned knee replacement therapy History: SOB Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Mild cardiomegaly again noted. Tortuous and atherosclerotic aorta, as before.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: ETT check ETT remains within 2 cm of the carina. NG and bilateral pulmonary artery infusion catheters appear unchanged in position.Cardiopulmonary appearance is limited due to motion. Concern for moderate CHF with associated superimposed left lower lobe consolidation and/or atelectasis persists with moderate effusions and cardiomegaly

Output: ETT unchanged


Instruction: Generate impression based on medical findings.

Input: Reason: rule out chest metastasis History: hx of renal cell carcinoma Unremarkable cardiac and mediastinal silhouette. Healed anterior rib fractures bilaterally.No sign of metastasis or a significant change.

Output: No evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 36 years old.Reason: sob History: sob, cough Interesting pattern of hazy opacities throughout the lungs most severe at the lung bases with superimposed microcystic basilar abnormality. Unchanged cardiomegaly. Enlarged central pulmonary arteries again noted. No large pleural effusion.

Output: Probable interstitial lung disease, slightly worse compared to previous study, which may represent worsening interstitial lung disease or superimposed edema. Moderate cardiomegaly and enlarged central pulmonary arteries again noted.


Instruction: Generate impression based on medical findings.

Input: Cough for 2 weeks Moderate COPD and interstitial changes greater in both lung bases, chronic in appearance. No superimposed acute abnormalities observed, specifically no effusions.Cardiac and mediastinal contours are within limits. Pronounced scoliosis

Output: Chronic-appearing interstitial changes without evidence of superimposed new acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: 83-year-old female with history of lymph node enlargement CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules are unchanged. Index left upper lobe nodule measures 5-mm image number 16, series number 6.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall mass measuring 2.9 x 1.6 cm on image number 14, series number 4. This mass is isodense to the surrounding musculature and in retrospect, it was present on the previous study measuring 2.5 x 1.9 cm on image number 12, series number 6.Borderline enlarged right axillary lymph nodes. Index node measures 9 mm in diameter on image number 16, series number 4, not significantly changed from previous study. Small left axillary lymph nodes are also unchanged.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific, scattered punctate hypodense lesions in the liver, too small to adequately characterize.SPLEEN: UnremarkablePANCREAS: Cystic lesion in the body and head of the pancreas are grossly unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts are unchanged. Left lower pole renal stone is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.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: Right chest wall mass and borderline enlarged right axillary lymph nodes, minimally enlarged to a stable.Scattered micronodules are stable. Spiculated left upper lobe nodule is stable.Other findings are also stable compared to previous study.These findings are discussed and acknowledged by Dr. Chhablani


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: s/p LVAD, evaluate pump positioning, tube feeding view so the entire pump is visible. Thank you. History: s/p LVad LVAD position is not substantially changed compared to last study. Cardiac leads, unchanged. New small left pleural effusion. No pneumothorax. Unchanged cardiomegaly.

Output: LVAD position is not substantially changed compared to last study. New small left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p bx with PTX on thursday. eval change. no chest tube placed History: cough Enlarged globular cardiac silhouette consistent with cardiomegaly and pericardial effusion.Pulmonary vascular redistribution.Small bilateral pleural effusions with basilar atelectasis, greater on the right.Almost complete interval resolution of a small right pneumothorax.

Output: Almost complete resolution of a right pneumothorax.Pericardial effusion and CHF, unchanged.


Instruction: Generate impression based on medical findings.

Input: Shoulder pain Right shoulder Severe degenerative changes are again observed with extensive subchondral cysts, narrowing and sclerosis with osteophytes. Scattered calcifications in the rotator cuff are also observed, compatible with old unchanged tendinosis and acromiohumeral narrowing consistent with rotator cuff tear. No findings to suggest dislocation or new abnormalityPronounced tortuosity of the aorta and atherosclerotic disease similar to prior chest x-raysLeft shoulder: Similar to right-sided severe osteoarthritic changes and rotator cuff changes.

Output: Severe bilateral shoulder osteoarthritic changes


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: r/o pneumonia History: wheezing, leukocytosis 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: 55 yearsGender: FemaleReason for Study: Reason: cough History: cough The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Reason: edema, infiltrate History: CP, sob The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary processes.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: fever, assess for new infiltrates History: fever, assess for new infiltrates New left lower lobe consolidation with left pleural effusion suggestive of infection or aspiration.Right jugular catheter, tip at cavoatrial junction level.

Output: New left lower lobe consolidation suggestive of pneumonia or aspiration.


Instruction: Generate impression based on medical findings.

Input: 64-year-old male with history of ocular lymphoma CHEST:LUNGS AND PLEURA: Bilateral dependent atelectasis.MEDIASTINUM AND HILA: Patient's known present aortic region adenopathy is stable. No new adenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter benign hypodensity.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign bilateral simple cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Reference mesentery lymph node measures 17 x 12 mm on image number 129, series number 3, slightly enlarged compared to previous study. Another reference mesenteric lymph node measures 2.1 x 1.7 cm image no 150, series number 3, enlarged from previous study.. A third reference mesentery lymph node measures 5.2 x 3 .1-cm image number 142, series number 3, enlarged from previous study.Borderline enlarged retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Please see discussion above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Interval increase in the size of the mesenteric lymph nodes.


Instruction: Generate impression based on medical findings.

Input: Heart failure Cardiac cannula, mediastinal chest tubes and ICD are unchanged. Swan-Ganz projects into the main pulmonary flow tract projected towards the right pulmonary artery.Moderate nonspecific cardiomegaly with underlying compression atelectasis or partial consolidation with mild air bronchograms left lower lobe. Right lung remains clear

Output: Chest tubes unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Status post cardiogenic shock. Possible PE. AMS, stroke with tachypnea and somnolence. Cardiomegaly enlargement of the central pulmonary vasculature. Diffuse interstitial abnormality with mild thickening of the fissures, superimposed mild ground glass opacity, bronchial wall thickening and airspace process left lower lobe. Enteric tube sidehole above the GE junction.

Output: Moderate acute pulmonary edema. Signs of pulmonary hypertension. NGT may be advanced.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: Evaluate LIJ line History: Evaluate LIJ lines The left IJ central venous catheter overlies the SVC.Very limited assessment of the cardiac mediastinum. Status post valvular replacement.Low lung volumes. Multilobar bandlike opacities represent subsegmental atelectasis. Suggestion of right basilar consolidation, poorly defined in this single AP projection.Small bilateral pleural effusions are noted. No pneumothorax.

Output: Left IJ central venous catheter overlies the SVC.Very limited assessment of the lungs due to expiratory projection. Small bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Hypoxemia Interval reversal and now complete opacification of the left hemithorax with enlarged pleural effusion and underlying collapse lung again observed. Moderate to large layering effusion on the right is also identified essentially unchanged. Superimposed nonspecific patchy opacities are seen throughout the right lung, concerning for edema versus infection.NG tube has been placed, side port seen approximately at the level of the GE junction. Multiple right and left biliary stenting

Output: Interval left hemithorax complete opacification and suspected atelectatic collapse from an increasing left large effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney Transplant Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old.Reason: lung infiltrate History: Chest pain; SOB cough Small lung volumes with unchanged chronic appearing pulmonary opacities.No specific evidence of infection or edema.Right central catheter tip at cavoatrial junction. Left subclavian ICD, leads unchanged in position.

Output: Unchanged chronic appearing interstitial opacities and support devices.


Instruction: Generate impression based on medical findings.

Input: Male; 59 years old. Reason: hx of radical nephrectomy, evaluate for metastatic disease History: see above Normal cardiac and mediastinal silhouettes. No abnormal pulmonary opacities or pleural effusions.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Age: 66 yearsGender: MaleReason for Study: Reason: Pt is a 66 y/o male with h/o pleural effusion, complaining of pleuritic pain, evaluate for worsening effusion History: pleural effusion, bladder cancer Right Port-A-Cath tip in the SVC.Bilateral pleural effusions right greater than left similar to the prior exam.Interval improvement in the interstitial opacities.No new pulmonary opacities identified.Median sternotomy intact.

Output: Small pleural effusions, right greater than left unchanged. Interval improvement in the interstitial opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: post op, intubated History: same Lines and tubes are unchanged. Unchanged bibasilar opacities and pleural effusions. Unchanged cardiomegaly. No pneumothorax.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 81-year-old male with multiple trauma CHEST:LUNGS AND PLEURA: Nonspecific punctate nodule in image number 80, series number 5 in the left lower lobe. Biapical scarring.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Postsurgical changes and a vascular graft in the left groin.

Output: No evidence of adenopathy.


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: s/p TAVR History: s/p TAVR Status post aortic valve replacement. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Calcified atherosclerosis of the aortic arch.

Output: Status post valve replacement without pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female 46 years old with history of seizure, evaluate for pneumonia, pulmonary edema Stable cardiomediastinal silhouette. Bibasilar atelectasis/consolidation worse on the left. No pleural effusions.

Output: Bibasilar atelectasis/consolidation with suspicion for aspiration pneumonia on the left.


Instruction: Generate impression based on medical findings.

Input: 55-year-old male with history of colorectal cancer status post chemotherapy, radiation therapy, and surgery. Compared to CT of 10/07. CHEST:LUNGS AND PLEURA: Biapical scarring. No nodules suspicious for metastatic disease.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Tiny hypodense nodule in the dome of the right lobe liver (image 61; series 80360) is stable and too small to characterize measuring less than 5 mm in diameter.SPLEEN: No significant abnormality notedKIDNEYS, URETERS: Simple, exophytic right lower pole cyst.ADRENAL GLANDS: 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 notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Previously described thickened small bowel loops are less prominent on the current exam.Presacral soft tissue density containing air is again noted and unchanged. A recent barium enema noted surgical leakage at this point. Please refer to that report for further details.BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality notedd

Output: 1. Air again noted in the presacral soft tissue density. Please refer to recent barium enema for further details of described "contained leak."2. Wall thickening of the pelvic small bowel described previously is less prominent on today's exam.3. Tiny hypodense nodule the liver is stable and too small to characterize


Instruction: Generate impression based on medical findings.

Input: Reason: fluid overload? History: edema increased creatinine Moderate cardiomegaly with a pacemaker lead in place, unchanged from previous.Increased opacity at both lung bases, greater on the left is nonspecific but consistent with atelectasis and possibly pleural effusion.No specific evidence of pulmonary edema.

Output: Basilar atelectasis and possibly pleural effusion. No specific evidence of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 31 years old.Reason: SOB, chest pain, difficulty with deep inspiration History: SOB, chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Cholecystectomy clips noted.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 36-year-old female with SLE, anti-phospholipid antibody syndrome and history of pulmonary embolism have shortness of breath and tachycardia. PULMONARY ARTERIES: Diagnostic examination demonstrating no pulmonary embolism.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No evidence of acute pulmonary embolism.


Instruction: Generate impression based on medical findings.

Input: Assess edema, hypoxia. Interval removal of right jugular catheter without pneumothorax. Left subclavian central line unchanged. Enteric tube terminates in the stomach with sidehole just beyond the GE junction. Swan-Ganz catheter has also been removed.Worsening pleural fluid. Diffuse edema-like opacities bilaterally about the same. Retrocardiac consolidation on the left slightly worse.

Output: Worsening CHF. Left lower lobe consolidation suspicious for pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Reason: leukocytosis History: leukocytosis Cardiomegaly, but resolution of prior opacities and pleural effusions.No specific evidence of infection.

Output: Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.AICD. Presternal ICD tip projecting over the level of the the aortic arch. Left chest wall subcutaneous generator with surrounding subcutaneous emphysema presumably post procedural.Unchanged cardiomegaly. No pneumothorax. Enlarged central pulmonary vasculature consistent with pulmonary hypertension. Chronic appearing interstitial lung abnormality, nonspecific and unchanged. No acute pulmonary abnormality.

Output: No pneumothorax or other acute pulmonary abnormality. Presternal ICD in expected position on this single view, positioning can be confirmed with lateral radiograph if required.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: follow up exam for pulmonary edema History: pulmonary edema Gradually worsening air space opacities suggestive of multifocal infection or aspiration.A Dobbhoff tube extends below the lower margin of the image.Left PICC, tip in axillary region.

Output: Gradually worsening pulmonary opacities consistent with multifocal infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: chest pain, SOB History: chest pain, SOB Large lung volumes. Heart size is within limits of normal. Pleural spaces are clear.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: et tube History: intubated ET tube tip 6 cm above carina. NG tube tip in stomach.No new opacity.

Output: ET tube tip 6 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: eval for pulm edema History: SOB Marked cardiomegaly/pericardial effusion. Patient is status post sternotomy.No large pleural effusions or pneumothorax. No focal pulmonary opacity.

Output: Marked cardiomegaly/pericardial effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Pneumothorax post device placement in EP lab. Left subclavian ICD lead terminates in the projection of the right ventricle. Bioprosthesis in the pulmonic valve position in this patient with presumed Tetralogy of Fallot. Unchanged cardiomegalyImproved lung volumes, though they remain low normal.No pneumothorax. No evidence of pulmonary edema. Linear subsegmental atelectasis or scarring in the right lower lung field.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: 79F with history of bladder cancer. surveillance imaging History: history of bladder cancer Chronic basilar interstitial abnormality is unchanged. No new pulmonary nodules.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 87 years old.Reason: reaccumulation of pleural effusion? need for repeat thoracentesis? 87M new dx renal cell ca History: pain left side Diffuse edema-like opacities are unchanged but there has been improvement in left lower lobe consolidation.Small pleural effusions are present.

Output: Improvement in left lower lobe consolidation, and stable edema-like opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: 79 yo M with AMS, delirium, elevated WBC, r/o infection History: AMS. Right PICC tip in the SVC. New enteric tube terminating beyond the field-of-view. Left subclavian AICD unchanged. Median sternotomy and postsurgical changes related to CABG redemonstrated.Small bilateral effusions, left greater than right. Persistent right basilar peripheral opacity and retrocardiac opacity.No pneumothorax.Stable cardiomediastinal silhouette.Right upper lobe granuloma again noted.

Output: No significant interval change in right basilar and retrocardiac opacities and small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: assess for edema, signs bleeding - pt with hemoptysis History: assess for edema, signs bleeding - pt with hemoptysis Tracheostomy remains in place. Unchanged cardiac leads. Improvement in basilar predominant pulmonary opacities. Small pleural effusions. Unchanged cardiomegaly. Bullet overlies the right lateral hemithorax, as before.

Output: General improvement in pulmonary opacities which may represent edema, infection, and/or pulmonary hemorrhage.


Instruction: Generate impression based on medical findings.

Input: Reason: Hx of testicular cancer, eval for metastastic disease History: As above Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Rule out fracture, status post fall. Now with bruising and left arm pain Humerus: No radiographic abnormalityChest: No cardiopulmonary abnormality. Specifically no rib fractures.

Output: Normal exam


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p lung transplant Support devices unchanged including ECMO catheter.Extensive bilateral pulmonary opacities demonstrating slight interval improvement.Stable cardiac mediastinal silhouette.Moderate sized bilateral apical pneumothoraces now identified.

Output: Support devices unchanged. Mild interval improvement in the bilateral dense pulmonary opacities. Bilateral apical pneumothoraces now identified in the presence of basilar chest tubes.


Instruction: Generate impression based on medical findings.

Input: 30-year-old female presents after being assaulted. There is a clinical concern for pneumothorax. Cardiomediastinal silhouette is normal. No focal opacity, pneumothorax, or pleural effusion. No rib fractures identified given the limitations of a chest radiograph.

Output: Normal radiographs of the chest. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: evaluate mediastinum and air spaces History: chest pain radiating to back Cardiomegaly with a moderate size hiatal hernia and a tortuous aorta, unchanged.No specific evidence of infection or edema.

Output: Cardiomegaly and a hiatal hernia with a tortuous aorta, unchanged. No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: Evaluate for V/Q scan History: As above The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Dilated colon. Currently treated for esophageal adenocarcinoma. Possible infiltrate in the right middle lobe and right lower lobe. Blood cultures positive for gram-negative bacilli. Abdominal pain. CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. Previously described consolidation the right lower lobe is unchanged. Previously described emboli in the right lower lobe not as well seen. The pleural effusion is decreased in size.MEDIASTINUM AND HILA: Extensive mediastinal adenopathy is unchanged. Reference subcarinal adenopathy measures 2.9 by 1.8 cm on image number 43, series number 3. Right hilar adenopathy is also unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Previous described subcentimeter nodule in the left lobe is not visualized. A new more anteriorly located hypodense lesion measuring 9-mm in the left lobe as seen on image number 84, series number 3. This is too small to accurate characterize but metastatic lesion cannot be excluded.SPLEEN: No significant abnormality notedPANCREAS: Ill-defined pancreatic mass in the head of the pancreas with metallic stent is unchanged. Peripancreatic adenopathy measures 2.9 x 2.8 cm on image number 90, series number 3.ADRENAL GLANDS: Right adrenal metastatic mass measures 2.3 x 2.1 cm. left adrenal gland is unremarkable.KIDNEYS, URETERS: Nonobstructing left subcentimeter renal stoneRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy. Reference para-aortic lesion measures 2 x 1.7 cm in image number 130, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of fluid in the pelvis.

Output: Metastatic mediastinal and retroperitoneal adenopathy, right adrenal lesion.. Right lower lobe consolidation is unchanged. Subcentimeter hepatic lesion suspicious for metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: CF with worsening cough History: cough Small lung volumes with bronchiectasis and patchy pulmonary opacities consistent with known cystic fibrosis.No specific evidence of superimposed edema or pneumonia.No significant pneumothorax.

Output: Unchanged chronic opacities consistent with known cystic fibrosis without evidence of superimposed infection or edema.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old, with shortness of breath. Evaluate for complicated pleural effusion. History of metastatic breast cancer obtained on a prior radiology requisition. LUNGS AND PLEURA: Numerous pulmonary nodules and masses are reidentified compatible with metastatic disease. A number of these masses are unchanged or slightly smaller, including the reference right lower lobe mass which measures 2.9 by 3.1 cm on image 51, series 5, not significant changed. Numerous other lesions, however, are new or larger, particularly those in a subpleural distribution. For reference, a right paracardiac nodule measures 1.1 by 1.0 cm on axial image 36, series 5, while previously this lesion measured less than 2 mm.Right pleural effusion has resolved. A left pleural effusion is larger.MEDIASTINUM AND HILA: Conglomeration of right paratracheal lymph nodes measures 2.5 x 2.1 cm on image 15, series 3. Accurate comparison with the most immediate prior exam is not possible due to technical factors. When compared to the examination of 6/27/08, these lymph nodes have increased (previously 1.6 x 1.9 cm).CHEST WALL: Right axillary reference lesion measures 3.2 by 3.6 cm on image 14, series 3, compared to 3.6 x 2.8 cm. This interval change is of uncertain significance given changing morphology. Very subtle progression of diffuse skeletal metastases is noted as well.UPPER ABDOMEN: Scattered hepatic metastases are slightly more numerous.

Output: Mixed response, but overall progression of disease.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: initial stroke workup History: right hemiparesis No pleural effusion or pneumothorax. No focal pulmonary opacities. The cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: Eval DHT replacement, etiology for desaturation History: Thick secretions Mild interstitial opacities unchanged, possibly aspiration related.Heart size normal status post sternotomy.Tracheostomy tube tip 7 cm above the carina.A Dobbhoff tube terminates in the stomach.

Output: Dobbhoff tube advanced into the stomach. Unchanged basilar interstitial opacities and no new findings.


Instruction: Generate impression based on medical findings.

Input: Dyspnea and Pleurx removal Interval removal of the right chest tube. The lungs are essentially similar in appearance demonstrating a persistent large right hydropneumothorax with layering of the effusion and extensive perihilar mixed interstitial and airspace opacities with cardiomegaly. Concern for moderate CHF remains, however appearance is nonspecific. Aspiration should also be considered

Output: Right chest tube removed and persistent underlying mild to moderate hydropneumothorax, likely loculated


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Reason: desaturations History: as above Unchanged pleural effusions and mild basilar subsegmental atelectasis.An NG tube extends below the lower margin of the image.Right jugular catheter, tip at cavoatrial junction.Sclerotic metastases unchanged.

Output: Stable pleural effusions and basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: post op, eval lung fields History: s/p ASD repair Is ET tube tip approximately 5 cm above the carina.Venous catheter is in the area off the right jugular and innominate veins.Small lung volumes with no gross abnormalities.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Check IABP IABP marker remains projected into the aortic arch similar position. Atherosclerotic changes and tortuosity aorta with mild cardiomegaly appears similar. Lungs are grossly clear. See subsequent report

Output: IABP is unchanged


Instruction: Generate impression based on medical findings.

Input: 70 year-old male with prostate cancer status post six cycles of chemotherapy. Evaluate disease status. CHEST: LUNGS AND PLEURA: Stable mild right lower lobe bronchiectasis. Bilateral mild emphysema, more prominent in the upper lobes. MEDIASTINUM AND HILA: No significant lymphadenopathy.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: Small left adrenal nodule is unchanged. KIDNEYS, URETERS: Small left renal cysts are unchanged. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Stable right lower quadrant ileostomy with peri-stomal herniation of nonobstructed bowel loops without evidence of obstruction. Small amount of fat stranding surrounding the intra-abdominal loops of bowel nearby the ostomy site may be due to inflammatory changes. No free air or abscess are found.BONES, SOFT TISSUES: No significant abnormality noted PELVIS: PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: The urinary bladder is collapsed around a suprapubic catheter. Bladder wall is thickened. Status post cystectomy with neobladder.LYMPH NODES: No significant abnormality noted BOWEL, MESENTERY: No significant abnormality noted BONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.

Output: Stable examination without evidence of recurrent or metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: interval change interstitial edema History: hypoxia Emphysema with superimposed left upper lobe predominant interstitial opacities suggestive of edema or aspiration, unchanged.Small pleural effusions.Heart size at least upper normal.

Output: Emphysema and superimposed edema or aspiration, unchanged.


Instruction: Generate impression based on medical findings.

Input: Dyspnea Again no superimposed acute cardiopulmonary abnormality. Diffuse mild chronic interstitial changes again presumably long-standing. No effusionsModerate tortuosity aorta and calcified hilar and mediastinal lymph nodes, compatible with old healed granulomatous disease exposure

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Age: 64 yearsGender: MaleReason for Study: Reason: chest pain r/o dissection History: chest pain Stable cardiomediastinal silhouette.Basilar interstitial opacities similar to the prior exam.Evidence of prior surgery in the right midlung.No new pulmonary opacities identified.

Output: Stable cardiopulmonary appearance with nonspecific basilar interstitial opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: r/o mass, pna History: sob No significant cardiopulmonary abnormality.

Output: No significant abnormality. No evidence of infection or mass identified.


Instruction: Generate impression based on medical findings.

Input: Bladder cancer No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Cough and shortness of breath. Right jugular chest port tip in the right atrium. Lower retrosternal opacity correlates to the mass seen on a subsequent CT. Normal heart size. Large lung volumes. Scarring in the right upper lobe. Small right pleural effusion with associated atelectasis.

Output: Retrosternal mass. Small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Partial nephrectomy. Sleep apnea Interval placement of a partially visualized surgical drain projected over the left upper quadrant. Mild overlying chest and abdomen wall emphysema. No overt associated super diaphragmatic abnormality, specifically no evidence of a pneumothorax.Decreased lung volumes with streaky densities in both bases suggesting atelectasis. The cardiac and mediastinal contours are grossly within limits given positioning and techniqueInterval removal of the left PICC line

Output: Abdomen drain placed in left upper quadrant without a supra diaphragmatic associated complication


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: cough, short of breath History: cough, short of breath Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Evaluate for pneumothorax Extensive subcutaneous emphysema. Partially imaged left-sided chest tube.Cardiomediastinal silhouette is normal.Small bilateral apical pneumothoraces.Bibasilar atelectasis and scarring without new focal airspace opacity.

Output: Small bilateral apical pneumothoraces.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: r/o infiltrate History: SOB Mild cardiomegaly.No specific evidence of infection or edema.

Output: Mild cardiomegaly, but no sign of infection or edema.


Instruction: Generate impression based on medical findings.

Input: 16-day-old male with pneumothorax and chest tube placement. Evaluate.VIEWS: Chest and abdomen AP (2 views) 11/28/2015, 0741 There are 2 right-sided chest tubes, unchanged in position. Endotracheal tube tip is between thoracic inlet and carina. Enteric tube with tip in the proximal gastric body. Left lower extremity PICC with tip obscured by overlying chest lead but likely in the right atrium.No significant interval change in the right pneumothorax, including the subpulmonic, medial, and apical components. The right lung is compressed. No significant interval change in the coarse left pulmonary opacities with superimposed left upper lobe opacity. No left pleural effusion or pneumothorax. Cardiac silhouette is normal in size.Unchanged gasless abdomen. No portal venous gas or pneumoperitoneum.

Output: Unchanged large right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 45 yearsGender: FemaleReason for Study: Reason: Suspicion of pneumothorax on attempted rt subclavian central line History: Suspicion of pneumothorax on attempted rt subclavian central line The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.The pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.History of pancreatic cancer and decreased breath sounds. Right Port-A-Cath tip in the cavoatrial junction.Cardiomediastinal silhouette is unremarkable.Low lung volumes. Subtle opacities in the costophrenic angles compatible with small pleural effusions and atelectasis. No pneumothorax.

Output: Small lung volumes likely due to increased intra-abdominal pressure.Subtle opacities in the costophrenic angles compatible with small pleural effusions and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male 58 years old Reason: assess for PNA or aspiration History: HIV, cough No focal airspace opacity.No pleural effusion or pneumothorax.The cardiomediastinal silhouette is unremarkable.

Output: No specific evidence of edema or infection.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: evaluate for retained broken catheter tip History: L IJ Hickman catheter dislodged Large central pulmonary arteries consistent with pulmonary arterial hypertension.Small lung volumes.No radiopaque foreign object.

Output: No radiopaque foreign object. Pulmonary arterial hypertension noted.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: SOB with bilateral edema, assess for pulm edema vs PNA History: SOB Small left pleural effusion with adjacent subsegmental atelectasis.No reliable evidence of infection, however.Heart size normal.

Output: Nonspecific left pleural effusion with adjacent subsegmental atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: cardiogenic shock eval lung fields History: as above Cardiopulmonary monitoring and support devices, unchanged.Cardiomegaly with bilateral opacity compatible with edema, atelectasis and small pleural effusions.Partial resolution of right upper lobe opacity.No new findings.

Output: CHF with no acute change.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: post lung biopsy. Question small pneumo. History: none There are decreased lung volumes.The current mediastinal silhouette is unremarkable.Numerous pulmonary nodules better defined on CT.No evidence of a pneumothorax post procedure.

Output: No pneumothorax identified.


Instruction: Generate impression based on medical findings.

Input: Male, 42 years old.Reason: chest pain, shortness of breath, eval for CHF History: chest pain, shortness of breath Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 31 yearsGender: MaleReason for Study: Reason: cough, fever History: cough,fever Left retrocardiac airspace opacity compatible with acute infection.The cardiac mediastinal silhouette is unremarkable.No pleural effusions.

Output: Left retrocardiac air space opacity compatible with infection. Attending ED physician notified by phone at 8:30 AM on 3/21/2016.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: icu History: icu Cardiomegaly with mild edema and pleural effusions, not significantly changed.ICD and LVAD unchanged.Right jugular catheter, tip in SVC.

Output: Cardiomegaly and mild edema, with stable support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old.Living kidney donor evaluation. Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: Normal chest radiograph.


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.Reason: evaluate pneumonia History: R Lower lung crackles, cough Mild cardiomegaly with a tortuous aorta.No specific evidence of infection or edema.Left subclavian pacemaker, leads unchanged in position.

Output: Mild cardiomegaly, without evidence of edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Weakness and altered mental status question pneumonia. Left jugular catheter tip in the right atrium.Elevation of the left hemidiaphragm with intrathoracic herniation of the stomach.Small left pleural effusion about the same.Compressive atelectasis of the left base and paramediastinal left upper lobe.No specific evidence of pulmonary edema.

Output: No visible signs of pneumonia however please note that much of the left lung is obscured and cannot be adequately assess on a single view portable radiograph.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: Febrile, evaluate pulmonary status History: Febrile, evaluate pulmonary status Left lower lobe consolidation is slightly worsened, with a left pleural effusion. This could represent pneumonia or simply atelectasis from mucous impaction.Right lung unremarkable.Heart size normal. Upper abdominal and stable in position.

Output: Left lower lobe consolidation, slightly worse, possibly infection.


Instruction: Generate impression based on medical findings.

Input: Age: 78 yearsGender: MaleReason for Study: Reason: bilateral pneumothoraces History: as above Tracheostomy tube unchanged.Moderate to large size left-sided pneumothorax redemonstrated.No right-sided pneumothorax noted.Stable cardiac mediastinal silhouette.

Output: Persistent moderate sized left-sided pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female 57 years old. Reason: rule out pneumonia History: COPD pt, 1 month SOB, fever 3 weeks ago. Cardiomediastinal silhouette is unremarkable.Large lung volumes suggestive of COPD. Poorly defined, nonspecific ground glass opacity in the right upper lobe which was not clearly seen on prior radiographs. This may correspond to reticulonodular opacities seen on recent CT. Known right basilar nodule is grossly stable and better characterized on recent CT examination. No specific evidence of infection.

Output: 1. COPD without evidence of pneumonia.2. Poorly defined, nonspecific ground glass opacity in the right upper lobe. This may correspond to reticulonodular opacity seen on recent CT, however, given the difference in modalities direct size comparison is difficult. This may warrant short term interval followup with CT. Findings were discussed by telephone with the emergency department physician, Dr. Twum, at 12:15 p.m.. on 4/26/2015. 2015


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Reason: abnormality History: weakness No significant cardiopulmonary abnormality.Spinal stabilization hardware noted in the lumbar region.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval pna History: fever Unremarkable cardiac and mediastinal silhouette. Bronchial thickening with mild streaky opacity at the right base, of uncertain chronicity but compatible with infection in the appropriate clinical setting.A questioned right upper lobe nodule probably represents superimposed vascular structures.A CT scan has been performed and provides more detailed evaluation.

Output: Mild right lower lobe opacity, of uncertain chronicity, but compatible with infection in the appropriate clinical setting.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: s/p intubation History: intubation Interval progression of left lung interstitial opacities. Line position stable.

Output: Interval progression of left lung interstitial opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: s/p AVR with CT removal; ?PTX History: SOB External fixation devices are intact. The cardiac mediastinal silhouette is unchanged. There has been interval removal of the mediastinal drain.Large lung volumes with flattening of the diaphragms compatible with COPD. Bilateral pleural effusions and mild basilar opacities appear unchanged.

Output: Bilateral pleural effusions and mild basilar opacities appear unchanged.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: chest pain, sob. acute pathology? pulm edema? pna? ptx? History: above The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: s/p intubation History: N/A Unchanged innumerable pulmonary nodules.Unchanged superimposed interstitial and airspace opacities and pleural effusions.Mild cardiomegaly.ET tube tip approximately 5 cm above the carina.

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


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old. AML status post new PICC line placement. Right PICC tip in the SVC.Left apical consolidation consistent with pneumonia, unchanged.Increased left basilar opacity consistent with atelectasis and possibly a small pleural effusion.

Output: Right PICC tip in the SVC. Increased left basilar opacity consistent with atelectasis and possibly a small pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Age: 19 yearsGender: MaleReason for Study: Reason: eval for infiltrate History: cough/chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Reason: New consolidation History: Fever Right upper lobe airspace and interstitial opacity, recently characterized by CT, not significantly changed.New embolization coils projected over the upper mediastinum and right apex.Probable small right pleural effusion.

Output: Status post embolization of right bronchial arteries and no other significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: 13043 bronchoscopy, flexible, pre-op lung status History: Large left pneumothorax with a deep sulcus sign, possibly a tension component.Chronic right hemithorax volume loss.Mild basilar subsegmental atelectasis.

Output: Large left pneumothorax, chest tube subsequently placed.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated History: intubated ET tube tip approximately 2 cm above the carina.Catheter tip in the SVC.Lower zone dependent opacity consistent with consolidation and atelectasis, likely secondary to aspirated secretions.No new findings.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 27 yearsGender: FemaleReason for Study: Reason: palpitations, sob History: palpitations, sob The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Female, 91 years old.Reason: cause of SOB History: SOB Bilateral pleural effusions and basilar opacities suggestive of edema and overlying atelectasis.Moderate cardiomegaly.

Output: Pulmonary opacities and pleural effusions with cardiomegaly, consistent with CHF.


Instruction: Generate impression based on medical findings.

Input: 72 year-old female with breast cancer known right pectoral recurrence. Evaluate disease status CHEST:LUNGS AND PLEURA: Fibrotic changes and volume loss right upper lobe, unchanged. No lung nodules or effusions.MEDIASTINUM AND HILA: Reference precarinal lymph node measures 1.9 x 1.5 cm. More properly measured on the prior exam as 2 x 1.5 cm on series 4 image 37 and therefore I believe it is unchanged. Other small superior paratracheal nodes are unchanged. Coronary artery calcifications.CHEST WALL: No previously seen right pectoral noted is not visible on measurable on the scan.Status post right mastectomy. Breast implant on the right.ABDOMEN:LIVER, BILIARY TRACT: Hepatic cyst unchanged. Mild dilatation common hepatic duct to 1.2 cm as seen on coronal image 68, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Multifocal cysts in the head body and tail of the pancreas redemonstrated. I PMNs cannot be excluded. This is probably causing compression of the common bile duct. There is no evidence of pancreatic ductal dilatation. A few pancreatic calcifications is seen enhancement process lateral aspect of the head. There are calcifications throughout the splenic artery however.ADRENAL GLANDS: 1.9 x 1.5 cm right adrenal nodule series 3 image 82 previously measured 1.8 x 1.2 cm.KIDNEYS, URETERS: Bilateral renal cysts stable.RETROPERITONEUM, LYMPH NODES: No atherosclerotic changes aorta no evidence of focal aneurysm. No pathologic sized retroperitoneal nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osteoporosis, scoliosis and degenerative changes. No lytic or blastic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Atrophic or surgically absent.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 pancreatic cyst or cystic lesions and stable mediastinal adenopathy. Right adrenal nodule. Other findings as above.


Instruction: Generate impression based on medical findings.

Input: Female, 29 years old.Reason: evaluated for pneumonia or pleural effusions History: shortness of breath and cough; intubated with general anesthesia for surgery one week ago 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: Female, 74 years old.Reason: ETT position History: ETT position Stable life support devices including right apical chest tube and endotracheal tube tip 3 cm above the carina.Stable cardiomediastinal silhouette.Stable perihilar vascular congestion and edema. Slight worsening in bibasilar pleural effusions and atelectasis, left greater than right. Previously described bibasilar nodular densities are less evident. No pneumothorax.

Output: 1.Slight interval worsening bibasilar pleural effusions and atelectasis, particularly on the left. Correlate with fluid status.2.Previously noted bibasilar nodular densities are less evident. Continued attention on followup imaging recommended.