Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: 84F w/ AMS, hypercarbic respiratory failure History: respiratory failure Patchy pulmonary opacities are stable, accompanied by small pleural effusions the right possibly improved.Right PICC, tip in the SVC.Right jugular catheter tip in right brachiocephalic.

Output: Stable pulmonary opacities. Unchanged catheters.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old. Overall amount of gaseous colonic dilatation similar to prior study. While degree of dilatation of sigmoid colon appears mildly improved, descending colonic dilatation mildly increased. No free air seen on semierect and decubitus imaging.Enteric tube seen with side-port just beyond gastroesophageal junction. Right chest wall port with tip near cavoatrial junction. Persistent right basilar airspace opacity.

Output: Colonic dilatation as above.Persistent right basilar airspace opacity.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: evaluate lung fields s/p heart transplant History: s/p lung transplant Median sternotomy for heart transplant, the heart size upper normal.Although small, the lungs are unremarkable in appearance.Remnants of a left subclavian ICD remain in the chest wall.Right jugular Swan-Ganz catheter removed leaving the introducer.

Output: No acute abnormality. No new findings.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Shortness of breath, rule out edema or pneumonia No specific evidence of infection or edema. Stable cardiac and mediastinal silhouettes.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: r/o pneumonia History: productive cough and dyspnea x 8 days Cardiomediastinal silhouette is unchanged. Mild elevation of the left hemidiaphragm. No specific evidence of infection or edema.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: r/o fluid overload History: esrd missed hd x 2 with sob + cough Right internal jugular central venous catheter tip terminates in the right atrium.There are mild basilar interstitial opacities may reflect mild interstitial edema, but this is equivocal. There may be small bilateral pleural effusions. There is no pneumothorax.Cardiomegaly unchanged.

Output: Equivocal mild interstitial edema and possible small bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: pna, asthma, pe History: pleuritic chest pain, sob Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Cardiogenic shock ETT persists 5 cm above the carina. NG tube projects into the mid gastric lumenModerate nonspecific cardiomegaly with mild mixed interstitial and airspace opacities concerning for edema with compression atelectasis greater on the left with a small effusion. See subsequent report

Output: ETT unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: eval for pathology, pna History: AMS Heart size normal, with a tortuous aorta.No significant pulmonary or pleural abnormality.

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


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Reason: confirm line placement History: as above Mild cardio megaly with small lung volumes.Right subclavian Swan-Ganz catheter tip in right pulmonary artery.Left subclavian ICD, leads unchanged in position.IABP proximal marker within 1 to 2 cm of the top of the aortic arch.

Output: Unchanged support devices. Cardiomegaly and small lung volumes, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Female, 77 years old.Reason: effusion? History: sob, adhf Bilateral pleural effusions with left basilar compression atelectasis and diffuse right-sided opacities consistent with known lung cancer, although which are stable.

Output: No change in bilateral pleural effusions and right-sided pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: ETT placement History: ETT Endotracheal tube tip 8 cm from the carina. Enteric tube terminates beyond the field-of-view.Superior mediastinal lymphadenopathy is redemonstrated, better evaluated on recent CT.No focal pulmonary opacity, pleural effusion or pneumothorax.Stable cardiomediastinal silhouette.

Output: Endotracheal tube tip approximately 8 cm from the carina.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p thora History: s/p thora Opacification of the right hemithorax consistent with a large pleural effusion and underlying atelectasis.Moderate shift of the mediastinal to the left.Left lung nodules consistent with metastases, better seen on the recent CT scan.Destructive metastasis in the right sixth rib laterally.

Output: Large right pleural effusion with no visible change.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: eval for PNA History: SOB and weakness Right chest port tip within the cavoatrial junction. Port is accessed. Stable cardiomegaly with tortuous aorta. Probable small left pleural effusion. No focal pulmonary opacity.

Output: Probable small left pleural effusion vs. thickening. No specific findings of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male 59 years old Reason: Evaluate 'pleurex catheter' Drainage catheter terminating in the right lung base.Heart size at the upper limit of normal.No pneumothorax.Possible small right pleural effusion.

Output: Surgical drain placement without pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: Increased SOB, hypoxia History: as above Examination is limited secondary to lack of grid device.Small lung volumes. Left basilar scarring. Increased rightward tracheal deviation with thickening of the right paratracheal [is likely secondary to positioning and motion artifact.

Output: Evaluation is limited. Deviation and right paratracheal deviation and right paratracheal stripe thickening likely secondary to patient positioning. Repeat chest radiograph is recommended if clinically warranted.


Instruction: Generate impression based on medical findings.

Input: Check for TB Mild calcified granulomatous scarring suggested in the left upper lung unchanged. No additional underlying cardiopulmonary acute abnormalities other than mild COPD changes

Output: Mild COPD with minimal old granulomatous disease exposure. Specifically no findings to support active TB


Instruction: Generate impression based on medical findings.

Input: Reason: new o2 req, altered History: see above Mild cardiomegaly.Diffuse nonspecific airspace and interstitial opacity with a differential diagnosis that includes edema and atypical infection.

Output: Diffuse nonspecific pulmonary opacity suggestive of edema or atypical infection with no significant interval change.


Instruction: Generate impression based on medical findings.

Input: Right foot ulcers. Check for pneumonia. Desaturation No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old. PICC tip in the left axilla.Port catheter with its tip in the SVC. Underinflated lungs with basilar opacities consistent with subsegmental atelectasis.Skin folds over the apices but no pneumothorax.

Output: PICC tip in the left axilla.


Instruction: Generate impression based on medical findings.

Input: Reason: vomiting blood History: vomiting blood Moderate cardiomegaly with a mitral valve prosthesis.Dual lumen catheter extending to the upper right atrium.Lower zone interstitial opacity compatible with edema with areas of subsegmental atelectasis, generally unchanged.

Output: Basilar opacity compatible with edema and atelectasis, without significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.History of mediastinal biopsy. Evaluate for pneumothorax. Large mediastinal mass with leftward tracheal deviation unchanged.Cardiac size unchanged.No new pulmonary airspace opacities or pneumothorax. Suspected small pleural effusions.

Output: Large mediastinal mass without pneumothorax. Suspected small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 25 years old. Reason: pna History: infxs workup Cardiomediastinal silhouette is unremarkable.No focal airspace opacity, pleural effusion, or pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Lung transplant Bilateral chest tubes remain well-positioned and unchanged in location. No significant associated pneumothoraces, a small gas collection remains in the left. Resolving chest wall emphysema bilaterally. Minimal basilar changes suggesting atelectasis without new acute focal abnormalityBorderline cardiomegaly. NG tube is coiled in the proximal stomach andPlaced

Output: Bilateral chest tubes unchanged and NG tube placed


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Status post CABG evaluate ETT, lung fields. Right jugular catheter tip at the SVC. Chest tubes project over the right apex and mid right lung.Low lung volumes with moderate pleural effusions bilaterally, extending into the fissures on the right and causing atelectasis. Small, less than 5 mm, right apical pneumothorax.

Output: No endotracheal tube is identified. Moderate volume of pleural fluid and atelectasis bilaterally.


Instruction: Generate impression based on medical findings.

Input: Reason: assess for infection History: assess for infection Heart size about upper normal with a tortuous calcified aorta.No acute abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old, history of non-small cell lung cancer, status post 4 cycles. CHEST:LUNGS AND PLEURA: A spiculated left upper lobe mass measures 2.8 x 1.7 cm on axial image 22/156, decreased from 3.1 x 2.1 cm on the prior exam. Associated interstitial thickening and ground glass opacities seen on prior exams are not evident on the current study suggesting improvement in lymphangitic disease.A left pleural effusion is slightly smaller. Continued improvement in left lower lobe aeration.A groundglass nodule in the right upper lobe measuring approximately 1.1 cm in diameter (axial image 34/156) is new. Additional scattered micronodules are unchanged.Right basilar interstitial and ground glass opacities are unchanged. Centrilobular and paraseptal emphysema, unchanged.MEDIASTINUM AND HILA: Right paratracheal reference lymph node measures 9 x 6 mm on axial image 35/156, unchanged. Subcarinal and paraesophageal lymph nodes are stable to slightly smaller (axial images 54 and 61/156). Right hilar lymphoid tissue, unchanged.Cardiac size is normal. Small pericardial effusion.Soft tissue nodule in the trachea (axial image 19/156) may represent aspirated secretions.Esophageal wall thickening, unchanged.CHEST WALL: Sclerosis at the right lateral aspect of the T5 vertebral body is unchanged. Sclerosis and deformity of the left third and ninth ribs may reflect old fractures. Stable sclerosis in the manubrium.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cystic lesions, unchanged.PANCREAS: Hypodense focus in the posterior aspect of the pancreatic body (axial image 95/156) is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small sclerotic focus in the right iliac wing, unchanged.OTHER: No significant abnormality noted

Output: 1.Interval improvement in reference measurements as well as other associated lung findings as described above.2.New, nonspecific right upper lobe ground glass micronodule.3.Stable bony sclerotic lesions.


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.Reason: AMS in liver disease, ? PNA History: AMS Improvement in right pleural effusion since the prior study with no pneumothorax if there has been a thoracentesis.Improvement in right basilar consolidation.Left PICC removed.

Output: Improvement in right pleural effusion and right basilar consolidation, and no new findings.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: ett in good place? History: ett Interval development of upper lobe opacities.No change in basilar opacities, left greater than right.Interval intubation with tip of the endotracheal tube 5 cm above the carina.Nasogastric tube placement with tip beyond the lower extent of the film.No pneumothorax.

Output: 1. Interval development of upper lobe opacities2. No change in basilar opacities3. Interval intubation.


Instruction: Generate impression based on medical findings.

Input: 67-year-old male with colon cancer CHEST:LUNGS AND PLEURA: Minimal left pleural thickening. Volume loss in the left lung base with atelectasis in the lingula. No nodules suspicious for metastatic disease.Calcifications and bilateral pleura, not significantly changed.MEDIASTINUM AND HILA: Tip of the Right-sided portacatheter is in the right brachiocephalic vein. Borderline enlarged. Mediastinal lymph nodes. A reference right paratracheal lymph node measures 20 x 13 mm image number 33, series number 3.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes in the liver. Cholelithiasis is unchanged. No focal lesions in the liver, suspicious for metastatic disease.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Fat-containing periumbilical hernia.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: Borderline enlarged mediastinal lymph nodes. Follow-up imaging is recommended. Left pleural thickening, bilateral pleural calcifications.The tip of the right, port catheter ends in the right brachiocephalic vein.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: Preop MVR History: Preop MVR Lower zone reticular opacities suspicious for chronic interstitial changes with bronchiectasis. No evidence of infection, pleural effusion or edema. Heart size is mildly enlarged.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Persistent decreased lung volumes with minimal basilar atelectasis. No distinct effusions or focal discrete airspace process.Moderate nonspecific cardiomegaly with a globular appearance raising concern for a questionable pericardial effusion.

Output: Borderline cardiomegaly


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: eval OG position History: as above Basilar opacities left greater than right with air bronchograms, slightly worse consistent with aspiration or evolving infection.Heart size normal.Tracheostomy tube tip approximately 5 cm above the carina.No NG tube identified despite the clinical history provided.

Output: Worsening basilar opacities left greater than right suggestive of infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Status post heart transplant. Sternotomy wires and plates, epicardial leads, mediastinal clips, and orphaned AICD leads in place, unchanged in position. Left PICC in place, unchanged. Moderate-sized right pleural effusion with underlying atelectasis/consolidation. Small left pleural effusion. Streaky left basilar opacity most consistent with subsegmental atelectasis. No evidence of pneumothorax.

Output: Persistent pleural effusions and bibasilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated, hypoxic History: intubated, hypoxic ET tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.Right jugular catheter tip in the SVC and on the left arm extending to the right atrium.Cardiomegaly with bilateral patchy airspace opacity, greater on the left, not significantly changed.Destructive lesion involving the right third rib laterally as previously characterized by CT scan.

Output: Severe nonspecific airspace opacity compatible with pneumonia, without significant change.A more recent radiograph has been interpreted.


Instruction: Generate impression based on medical findings.

Input: Reason: cough, SOB; eval for PNA, edema History: cough, SOB Unremarkable cardiac and mediastinal silhouette. Mild basilar scarring visible on the lateral view.No sign of pneumonia, edema or other acute findings.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 86 years old.Reason: Infiltrates History: fever Low lung volumes.Cardiomediastinal silhouette is within normal limits.No pneumothorax. No pleural effusion.No airspace or interstitial opacities.

Output: No signs of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Chest pain. Rule out infection/fluid. No focal pulmonary opacities, pleural effusions, or pneumothorax.Cardiomediastinal silhouette is within normal limits.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: assess for ETT positioning, changes in pulm edema History: hypoxia, s/p ETT ET tube tip 3 to 4 cm above carina.No change in patchy bilateral interstitial and airspace opacity suggestive of edema or ARDS. Infection or hemorrhage may appear similarly.

Output: ET tube tip 3 to 4 cm above carina.No change in patchy bilateral interstitial and airspace opacity suggestive of edema or ARDS. Infection or hemorrhage may appear similarly.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Intubated. Intracranial hemorrhage. Diffuse airspace opacities, right greater than left, probably unchanged allowing for decrease in dependent atelectasis. Small pleural effusions are improved and possibly resolved. Retrocardiac atelectasis is also improving. ETT unchanged in position. NGT tip off the caudal margin of the film.

Output: Improving pleural fluid. Diffuse pulmonary opacities remain severe.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: check PICC line placement History: malfunctioning central PICC (for home inotrope) Left-sided ICD unchanged.Right PICC line with its tip in the right axillary vein.Stable cardiac enlargement.The lungs are clear.No pleural effusions.

Output: Stable cardiac enlargement. Right PICC line with its tip in the right axillary/subclavian vein retracted from the prior exam.


Instruction: Generate impression based on medical findings.

Input: 53-year-old female with history of large B cell non-lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Small thyroid nodules.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Ill-defined hypodense lesion in the spleen measuring 2.5-cm in diameter image number 82, series number 3. This is suspicious for lymphoma involvement. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Ill-defined retroperitoneal infiltrative soft tissue density encasing abdominal aorta and IVC, suspicious for treated lymphoma involvement. It is difficult to provide a measurement of this infiltrative soft tissue density.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: Focal splenic lesions suspicious for lymphoma involvement. Ill-defined retroperitoneal soft tissue density suspicious for treated lymphoma.


Instruction: Generate impression based on medical findings.

Input: Assess for aspiration. Unknown if patient had seizures and might have aspirated. Persistent atelectasis in the left lung base, only minimally improved. Mild bronchial wall thickening. Low lung volumes. No focal airspace opacities.

Output: No signs of pneumonia. Bronchial wall thickening and atelectasis may be seen in the setting of aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: Preop CobraMaze History: Preop CobraMaze Large lung volumes are consistent with COPD.No specific evidence of infection or edema.Mild cardiomegaly noted, with a tortuous aorta.

Output: COPD and cardiomegaly, but no acute edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Left upper lobectomy. Chest tube placement. The lower left chest tube has been slightly repositioned. No significant sized pneumothorax. Enlarging left paramediastinal opacity which may reflect postoperative contusion/hematoma. Fluid in the seizure on the right with adjacent atelectasis about the same.

Output: No significant sized pneumothorax. Enlarging left paramediastinal opacity which may reflect postoperative contusion/hematoma.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: ? pna History: cough Leftward patient rotation and low lung volumes again limit detailed pulmonary evaluation.Bibasilar opacities are consistent with subsegmental atelectasis.No large pleural effusion or pneumothorax.Normal heart size.Hiatal hernia.

Output: Bibasilar subsegmental atelectasis. No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Swan placement. There is interval extubation and removal of enteric feeding tube. Right jugular Swan-Ganz catheter tip has been pulled back and tip is in the most proximal truncus anterior. Median sternotomy hardware is unchanged. Lower lung opacities compatible with edema and pleural effusions are similar compared to prior examination given differences in technique.

Output: Right jugular Swan-Ganz catheter tip has been pulled back and tip is in the most proximal truncus anterior.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Tachycardia, A. fib, evaluate effusion. Extensive opacification of the right hemithorax due to tumor about the same. Right basal Pleurx catheter in place. Only trace pleural fluid on the right. No acute abnormality on the left.

Output: Trace right pleural effusion; opacification of the right hemithorax is due to tumor.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: assess for evolving PNA History: Increasing O2 requirement Bilateral pleural effusions, with overlying consolidation, not significantly changed.Spinal stabilization hardware unchanged.

Output: Pleural effusions and basilar consolidation, not significantly changed.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: CHF, pacemaker position History: concern for pacemaker site infection Cardiomegaly status post median sternotomy for aortic valve replacement.Bilateral pleural effusions right larger than left, with basilar opacities suggestive of edema and atelectasis.Right jugular catheter tip at cavoatrial junction.Left subclavian pacemaker, leads in appropriate position.

Output: Cardiomegaly, pleural effusions and pulmonary opacities consistent with CHF.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Retained foreign body, unspecified material, thoracic dissection Interval intubation following redo sternotomy. Several mediastinal drains are in place. There is a right IJ Swan-Ganz catheter that terminates at the level of the pulmonic valve. Sternotomy hardware is well aligned. There is evidence of coronary arterial revascularization.Mild cephalization of blood flow with basilar opacities favoring subsegmental atelectasis. The heart size remains normal. No pneumothorax.Of note, this was an emergent operation with normal counts in the OR. No evidence of radiopaque foreign body. Findings discussed with the attending surgeon, Dr. Balkhy at 7:30 PM on 9/24/2015 by Dr. McCann.

Output: No evidence of radiopaque foreign body in this postoperative radiograph. Mild cephalization of blood flow without evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: SOB. Tubes and lines unchanged.Right hemithorax opacification has progressed, with an air-fluid level visualized on the lateral radiograph consistent with a very large hydropneumothorax.Atelectasis on the left.

Output: Large right hydropneumothorax with opacification of the right hemithorax..


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Reason: SOB evaluate for PNA History: SOB Increasing opacity in the left mid lung periphery could be a site of infection or artifact of overlying soft tissue.Cystic fibrosis with areas of mucoid impaction are unchanged.Heart size normal.Right jugular catheter, tip at right atrial level.

Output: Possible left midlung pneumonia, more likely summation artifact of overlying soft tissue.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: reassess pleural effusion History: pleural effusion No change in complete opacification of the right hemithorax. Left lung grossly clear. No pneumothorax.

Output: No change in complete opacification of the right hemithorax.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: FemaleReason for Study: Reason: ETT History: ETT ET tube with its tip 4 to 5 cm above the carina.NG tube with its tip in the margin of the image.Stable cardiomediastinal silhouette.No new pulmonary opacities identified.

Output: For device is unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Line evaluation. Cardiomegaly with CHF pattern is stable. ET tube is 6 cm above the carina. IABP marker stable over the proximal descending thoracic aorta. Right jugular Swan-Ganz catheter tip over the right main pulmonary artery. Numerous other lines and devices including ECMO tubing are stable. No measurable pneumothorax.

Output: Moderate CHF pattern stable. Numerous tubes, lines, and devices including IABP marker and ECMO apparatus, stable.


Instruction: Generate impression based on medical findings.

Input: Age: 67 yearsGender: FemaleReason for Study: Reason: eval for infiltrate History: cough, chest congestion Scarring/discoid atelectasis in the left midlung.No focal areas of consolidation.The cardiomediastinal silhouette is unremarkable.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Fever. An intraspinal anesthesia catheter terminates at the T9/T10 level. There is a portion of the catheter which is only faintly radiopaque and discontinuity cannot be excluded. Additionally, the catheter appears to be looped/tortuous in course just prior to entering the spinal canal where it overlies the T10 vertebral body.Subsegmental atelectasis right lung base. Diffuse hazy opacity throughout the left lung with retrocardiac atelectasis.Cholecystectomy clips.No pneumothorax.

Output: Diffuse opacities throughout the left lung suggestive of aspiration, recommend short-term follow-up chest radiographs to exclude development of aspiration pneumonia. The spinal anesthesia catheter appears discontinuous however this may represent a nonradiopaque portion of the catheter. Suggest correlation with bone-technique frontal thoracic spine radiograph for confirmation. WIGHTMAN, SEAN ( 2998 ) notified verbally of the time of dictation.


Instruction: Generate impression based on medical findings.

Input: Follow-up left lower lobe pseudoaneurysm Persistent moderate yet decreasing left pleural effusion with mild improving aeration of the decreased volumes related to a postsurgical left hemithorax. Right lung remains clearCardiac and mediastinal contours otherwise remain within limits

Output: Postsurgical left lower lobectomy with residual yet resolving pleural effusion


Instruction: Generate impression based on medical findings.

Input: Right PICC line check Interval retraction or replacement of the right PICC line, tip currently projects into the axilla short of the subclavian.Underlying persistent decreased lung volumes with basilar atelectasis greater on the left with questionable mild cardiomegaly and small left effusion. Lungs otherwise clear

Output: Right PICC line placed


Instruction: Generate impression based on medical findings.

Input: Reason: desat History: desat Moderate cardiomegaly.Volume loss in the left hemithorax consistent with atelectasis, and moderate left pleural effusion.Focal streaky opacity in the right lower lung consistent with subsegmental atelectasis.An arteriovenous malformation in the left lower lobe shown on a previous CT scan is obscured by overlying pleural effusion and atelectasis.

Output: Atelectasis, pleural effusion and left lower lobe arteriovenous malformation, shown on a previous CT scan.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Chest pain and shortness of breath. Right greater than left pleural effusions are unchanged compared to prior examination. There is right hemithorax volume loss with mediastinal shift, similar to prior. There is interval increase in interstitial opacities and bronchial wall thickening, suggestive of pulmonary edema.

Output: Interval increase in interstitial opacities and bronchial wall thickening, suggestive of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Status post right-sided thoracentesis. Interval improvement in right pleural effusion, left unchanged. Bibasilar streaky atelectasis and probable mild interstitial pulmonary edema. No evidence of pneumothorax.Cardiomegaly without silhouette unchanged.

Output: Interval improvement in right pleural effusion. No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluating for pna, immunosuppressed History: intermittent cough, sob x 1 month on humira \T\ azothioprine, no f/c, pulmnoary exam normal Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Check LVAD ICD and LVAD appear unchanged in within limits.Small pleural effusions with decreased lung volumes similar to prior however overall aeration has increased with residual minimal left and right basilar atelectasis. Borderline cardiomegaly

Output: Improving aeration and suspected decrease in size of now small to moderate pleural effusions


Instruction: Generate impression based on medical findings.

Input: Female, 31 years old.History of worsening asthma symptoms. The heart, mediastinum, lungs, pleural spaces and visualized bones are within normal limits.

Output: No radiographic findings to suggest pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 48 yearsGender: MaleReason for Study: Reason: recent SubQ ICD placement History: hx vf arrest, afib, s/p icd Motion limits sensitivity.Stable cardiac enlargement.Presternal ICD lead is identified.The lungs are clear.No pleural effusions.

Output: 3 sternal ICD lead poorly visualized with its tip at approximately the T8 level.


Instruction: Generate impression based on medical findings.

Input: Esophageal perforation, bowel distention Nasojejunal tube seen with tip beyond ligament of Treitz. Residual contrast seen throughout colon. Nonobstructive bowel gas pattern. Right upper quadrant surgical clips related to prior cholecystectomy. Bilateral total hip arthroplasties partially imaged. Right iliac/supraacetabular lytic osseous lesion. Multilevel spinal degenerative disease.Please refer to same day chest radiography for findings.

Output: Enteric tube as above.Evaluation for free air suboptimal as only supine imaging performed. If there is continued clinical suspicion, further assessment with upright or left lateral decubitus radiographic imaging recommended.Right iliac/supraacetabular lytic osseous lesion.


Instruction: Generate impression based on medical findings.

Input: Desaturation. Patient with thalassemia and acute short of breath Moderate nonspecific cardiomegaly with persistent chronic appearing interstitial opacities. No superimposed new focal airspace process.

Output: No interval change or new apparent acute superimposed process. Diffuse chronic interstitial changes


Instruction: Generate impression based on medical findings.

Input: 64-year-old female intubated during ERCP for c/f aspiration, just extubated in MICU, ?aspiration Feeding tube tip in distal stomach.There are increasing interstitial opacities with upper lobe redistribution which appear fibrotic. There is no superimposed infectious process. Right basilar opacity is nonspecific in appearance and could represent aspiration. No pleural effusion or pneumothorax.Cardiomediastinal silhouette is unremarkable.

Output: 1. Right basilar opacity is nonspecific and could represent aspiration.2. Bilateral fibrotic appearing changes in the lungs. This could be further evaluated with an upright PA and lateral chest radiograph or CT if warranted.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: chest tube placement History: s/p right thoracotomy RUL lobectomy resection ribs 2-4 Two right chest tubes with a 3.3 cm right pneumothorax. Status post right chest wall resection.Patchy atelectasis noted with right pleural effusion.ET tube tip approximately 4 cm above the carina.An NG tube terminates in the stomach.

Output: Right apical pneumothorax following chest wall resection.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Reason: r/o acute process History: right chest and back pain with shortness of breath The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Reason: Chest pain History: Chest pain Cardiomegaly with vascular redistribution. No sign of infection or edema.

Output: Cardiomegaly with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male 28 years old Reason: evaluation of PTX History: dyspnea Bilateral chest tubes in place, positions unchanged.Moderate left apical pneumothorax increased in size, small right apical pneumothorax similar to prior.Extensive cystic parenchymal disease compatible with LCH again seen.The cardiomediastinal silhouette is unremarkable.Chest wall subcutaneous emphysema similar to prior.

Output: Moderate left apical pneumothorax increased in size, small right apical pneumothorax similar to prior.


Instruction: Generate impression based on medical findings.

Input: 66 years old Female. Reason: assess swan History: hypotensive on pressors. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins. There is diffuse mild bilateral interstitial edema. The tubes and lines are stable in position.

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


Instruction: Generate impression based on medical findings.

Input: 68-year-old male with HCC. CHEST:LUNGS AND PLEURA: No significant abnormality noted. Pericardial and pleural effusions have resolved.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small liver with nodular contour consistent with cirrhotic morphology. There is a new 1.5-cm early-enhancing focus in segment 5 becoming isointense enhancing on portal venous phase. This most likely is a transient perfusion abnormality. Perihepatic ascites and varices suggest portal hypertension.SPLEEN: Splenomegaly, splenorenal varices.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Native kidneys are symmetrically atrophic. A right pelvic transplant kidney is partially visualized.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of ascites.

Output: 1. Small early enhancing focus in the right hepatic lobe without early washout, most likely representing a transient perfusion defect.2. Cirrhosis and findings consistent with portal hypertension.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o infiltrate History: shortness of breath Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: Chronic smoker, dyspnea History: dyspnea Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Pacemaker leads noted terminating in expected location of the RA and RV.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: SOB on 10 L NRB History: see above Severe interstitial opacities consistent with fibrosis are unchanged.No specific evidence of superimposed edema or pneumonia.Moderate cardiomegaly.

Output: Severe interstitial lung disease with cardiomegaly, unchanged.


Instruction: Generate impression based on medical findings.

Input: Sepsis. Line placement Tracheostomy tube remains 4 cm above the carina, however a slipped drain or intraesophageal device remains looped back upon itself at the level of the thoracic inlet, please correlate with patientRight jugular catheter extends into the upper SVC without interval significant change or postprocedural complication.Underlying cardiopulmonary appearance again demonstrates perihilar patchy opacities with marked cardiomegaly and suspected layering effusions. Moderate CHF

Output: Moderate CHF suspected


Instruction: Generate impression based on medical findings.

Input: Reason: et tube History: et tube ET tube tip approximately 2 cm above the carina.Bronchial valves in the right upper lobe bronchi.Diffuse mediastinal and subcutaneous emphysema, unchanged. Basilar atelectasis and small right effusion.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Reason: 42F with ARDS and hypoxemia History: on ventilator, s/p trach Tracheostomy tube and venous catheters unchanged. Small lung volumes with diffuse nonspecific interstitial and airspace opacities compatible with the clinical diagnosis of ARDS, not significantly changed.

Output: ARDS with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: swan placement History: swan palcement Swan-Ganz catheter tip in proximal right interlobar pulmonary artery. Other support hardware stable. No change in cardiomegaly and basilar edema and atelectasis.

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


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: chest pain, right sided, eval for PTX/PNA History: chest pain, right sided, eval for PTX/PNA Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: cough, SOB History: cough Cardiomegaly with equivocal basilar edema and mild retrocardiac atelectasis.Left subclavian presternal ICD unchanged.

Output: Cardiomegaly, and possible edema.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Productive cough, no improvement with antibiotics. Lung transplant 2008. Mild thoracic kyphosis. No pleural fluid or pneumothorax. Although the lung volumes appear decreased on the frontal radiograph, on the lateral radiograph they similar to the prior study. Dependent opacity may reflect atelectasis. No conclusive airspace opacities or signs of pulmonary edema.

Output: No specific signs of pneumonia. Lung volumes are probably similar to previous but this could be confirmed on a follow-up PA and lateral study if required.


Instruction: Generate impression based on medical findings.

Input: Female, 33 years old.Reason: sob History: SOB Lungs and pleural spaces are clear. The heart size is normal.

Output: No cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: AM CXR History: AM CXR Right chest port, tip at the cavoatrial junction. Postsurgical changes in the left upper chest. Multiple left-sided chest tubes and a chest wall drain appear similarly positioned, accounting for differences in patient positioning. Subcutaneous emphysema.Stable cardiomediastinal silhouette.Left upper lung opacity, likley postoperative contusion and atelectasis. No new focal air space abnormality. Probable small left effusion.

Output: Stable postsurgical findings in the left hemithorax, without new acute process.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: ILD History: As above Severe pulmonary fibrosis unchanged.The ET tube is no longer visible, presumably the patient extubated.An NG tube terminates in the stomach.Right jugular catheter, tip in SVC.

Output: Unchanged ILD. ET tube no longer visualized.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old.Reason: confirm IJ CVC placement History: Confirm IJ CVC placement Right IJ line terminates in the superior aspect of the SVC. Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: Right IJ line, as above. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old. NG tube is looped in the hypopharynx.Left upper lobe nodule, nipple shadows and small pleural effusions unchanged.Dilated loops of bowel visible in the upper abdomen.

Output: NG tube looped in the hypopharynx.


Instruction: Generate impression based on medical findings.

Input: 34-year-old man presents for preoperative (transplant) evaluation. Cardiomediastinal silhouette is within normal limits. No pulmonary opacity, pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality, without interval change.


Instruction: Generate impression based on medical findings.

Input: ETT check ETT remains 3 cm above the carina. NG projects beyond the inferior edge of the image. Underlying decreased lung volumes with new mixed patchy airspace and interstitial changes in both bases with cardiomegaly suggesting increasing mild edema. Appearance is exaggerated due to overlying artifact

Output: Increasing diffuse mild edema and suspected failure. See description provided


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: r/o L pneumo after attempted thora History: as above No pneumothorax following attempted thoracentesis.Left pleural effusion may have diminished in size.Patchy left base opacity improved.Streaky atelectasis right lower lobe.Right jugular catheter, tip in SVC.Tracheostomy tube tip approximately 6 above the carina.

Output: No significant pneumothorax. Improved left basilar consolidation.


Instruction: Generate impression based on medical findings.

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

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


Instruction: Generate impression based on medical findings.

Input: Reason: 56yo M w/ a hx of pleural effusion. Monitor for interval progression. History: SOB Cardiomegaly with An ICD lead extending to the area of the apex of the right ventricle, unchanged. Bilateral mainly interstitial opacity with multiple septal lines compatible with pulmonary edema and bilateral pleural effusions, greater on the right.

Output: CHF with pulmonary edema and pleural effusions, not significantly changed.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p AVR/MVR History: SOB Heart size about upper normal.Moderate bilateral pleural effusions with underlying atelectasis, greater on the left, slightly improved compared to previous.No new findings.

Output: Resolving pleural effusions and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: RIJ TLC placement History: line placed Patchy pulmonary opacities with focal areas of sparing, unchanged.ET tube low, at the carina level.Right jugular catheter, tip in SVC.An NG tube terminates in the stomach.

Output: Stable pulmonary opacities. Low ET tube.


Instruction: Generate impression based on medical findings.

Input: 33-year-old female rising WBC count delayed return of bowel function, status post ex lap, diverting loop ileostomy for colon perf. Please evaluate for PNA, intra-abdominal or intrapelvic abscess. May need CT-guided abscess drainage. CHEST:LUNGS AND PLEURA: Increasing moderate sized left pleural effusion with underlying atelectasis or consolidation. Small right pleural effusion.MEDIASTINUM AND HILA: Small shotty mediastinal nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small shotty retroperitoneal nodes.BOWEL, MESENTERY: Previous diffuse fluid collections are decreased in volume and generally more mature with numerous scattered fluid collections throughout the peritoneal cavity. Previously seen gas collections are resolved and there is no free air. In the upper abdomen dominant collection is caudal to the pancreas and dorsal to jejunum measured on series 3 image 94 2.5 x 2.4 cm.Expected postsurgical changes are redemonstrated. Midline surgical and. Left lower quadrant ileostomy. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: Air in urinary bladder presumably from instrumentation but no Foley catheter seen.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Numerous septated fluid collections are seen throughout the peritoneal cavity with dominant collection seen in the cul-de-sac and adnexa. Largest collection in the cul-de-sac which is septated as measured on series 3 image 164, 6.3 x 3.7 cm. most of the gas has been resolved although a few bubbles of extraluminal gas may persist superior to the left to the right adnexa.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Midline abdominal wound with some fat stranding and small amount of fluid in the wound.

Output: Numerous septated small collections throughout the peritoneal cavity in the abdomen and pelvis. Largest collection in the cul-de-sac septations. Increased left pleural effusion with underlying atelectasis. Other findings as above. Discussed with Dr. Cassandra Royce.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: eval ett placement History: see above ET tube tip at the thoracic inlet.NG tube with its tip beyond the margin of the image.Extensive bilateral airspace opacities and right basilar consolidation unchanged.No new pulmonary opacities.Bullet fragment overlying the right hemithorax redemonstrated.

Output: ET tube in a high position. Extensive pulmonary opacities without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for focal abnormality History: hx of mi, chest pain Mild cardiomegaly with coronary stents in place.No sign of pulmonary edema or infection.Prominent nipple shadows projected over the lungs bilaterally.

Output: Mild cardiomegaly with no acute findings.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: Pneumothorax; Post device placement in EP Lab History: Post device placement in EP Lab No pneumothorax status post ICD placement in expected location of the RV. Unchanged moderate cardiomegaly. Small pleural effusions. No new focal lung consolidation. Large patient body habitus.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: R/o misplacement of swan ganz History: CHF No significant cardiopulmonary abnormality.Right jugular Swan-Ganz catheter, tip in left descending pulmonary artery.

Output: Swan-Ganz catheter, tip in left descending pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: 64 year-old female with metastatic tonsil cancer to the lung on chemotherapy. LUNGS AND PLEURA: Multiple pulmonary nodules have all decreased in size. A reference right upper lobe nodule measures 10 x 11 mm (axial image 34/109), decreased from 13 x 15 mm on the prior exam. No new nodules are evident. No focal consolidation, edema or pleural effusion. Mild emphysema unchanged.MEDIASTINUM AND HILA: Left hilar lymphoid tissue is smaller measuring 13 x 12 mm on axial image 37/109 which is decreased from 16 x 16 mm. Additional pretracheal and prevascular lymph nodes are smaller as well.Cardiac size is normal with no pericardial effusion. Significant coronary and aortic calcifications noted with an atheroma evident in the ascending aorta, unchanged. The ascending aorta measures approximately 4.4 cm in diameter which is borderline enlarged but unchanged from prior.CHEST WALL: Sharply defined, sclerotic focus of uncertain etiology within the right pedicle of a midthoracic vertebral body shows no evidence of bony destruction and is unchanged over the prior two CT studies (axial image 68/109).UPPER ABDOMEN: Small cystlike lesion in the dome of the liver is unchanged. Multiple hypoattenuating lesions within both kidneys are re-identified and appear stable. The largest is off the superior pole of the left kidney and shows fine, enhancing internal septations but is unchanged from the prior exam. Continued follow-up recommended.Soft tissue density adjacent to the gallbladder wall is nondependent and evident on the prior exam as well. The clinical significance is uncertain, but a gallbladder wall abnormality cannot be excluded. Consider further evaluation with an ultrasound examination if clinical symptoms are suggestive.A G-tube is present in the stomach.

Output: Interval improvement in size of pulmonary nodules and lymphadenopathy with other stable findings and recommendations for follow up as above.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Check for pneumothorax post device placement in the EP lab. Left subclavian ICD with leads in the right atrium, right ventricle and a branch of coronary sinus. No pneumothorax. A portion of the left upper lobe is obscured by the pulse generator and cannot be assessed.The remainder of the lungs are without acute abnormality.

Output: No pneumothorax post left subclavian ICD placement.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: eval change History: intubated ET tube and jugular catheters in unchanged position.Stable cardiomediastinal silhouette.Stable bilateral extensive interstitial and air space opacities.

Output: Unchanged cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old. Reason: suspect lipoma left anterior superior chest wall Deep to the palpable area of concern in the left lateral chest wall, there is a heterogeneous, mildly echogenic, well marginated ovoid mass measuring 4.5 x 1.2 x 4.7 cm. No significant increased internal vascularity.No other lesions identified.

Output: A solid mass in the subcutaneous tissue of the left lateral chest wall has sonographic appearance favoring a lipoma.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: evaluate ET tube position History: above Lines and tubes are unchanged. Basilar pleuroparenchymal opacities, not substantially changed. Unchanged cardiomegaly. No pneumothorax

Output: No new focal pleural parenchymal opacity.


Instruction: Generate impression based on medical findings.

Input: Male, 19 years old.Reason: Eval for cardiopulmonary disease. History: Hemoptysis No significant cardiopulmonary abnormality.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: ptx History: ptx Right chest tube in place with a moderately large right pneumothorax, slightly decreased since the previous exam. Basilar opacity compatible with atelectasis and small effusions.

Output: Decreased right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 35-year-old male with lymphoma, splenomegaly CHEST:LUNGS AND PLEURA: Right lower lobe pulmonary micronodule, favor benign etiology.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Two subcentimeter hypodensities in the liver are too small to definitively characterize, but likely cysts.SPLEEN: A splenule is seen adjacent to the spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Enlargement of the sacral spinal canal is most likely due to dural ectasia.OTHER: No significant abnormality noted

Output: No definite CT evidence of lymphoma


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: eval lung fields History: pulmonary edema, ECMO Stable position of support devices.No change in bilateral pulmonary opacities.

Output: Stable support devices. No change in pulmonary findings.


Instruction: Generate impression based on medical findings.

Input: Female, 18 years old.Reason: Infiltrates History: Fever Low lung volumes likely explains crowding of the hilar structures.. No focal lung consolidation. No pleural effusion or pneumothorax. Normal heart size.

Output: Low lung volumes. No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Reason: et tube History: INTUBATED ET tube tip approximately 3 cm above the carina.NG tube tip in the stomach.Small lung volumes with no acute findings.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: eval pna, hx of OHT History: cough, fatigue Median sternotomy, heart size upper normal.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Chest pain evaluate for widened mediastinum or focal opacity. Normal heart size. No focal airspace opacity, pleural fluid or pneumothorax. Mild loss of height of mid thoracic vertebral bodies is chronic. No mediastinal widening.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 56-year-old male with newly diagnosed base of tongue cancer. Staging. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted. ABDOMEN:LIVER, BILIARY TRACT: Punctate hypoattenuating focus in segment 6 (series 4, image 133) is too small to characterize. Cholelithiasis without evidence of acute inflammation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, unchanged from prior study from 2006. Nonobstructing, 4-mm left renal stone.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel is only partially visualized; diverticulosis of the descending colon without acute inflammation.BONES, SOFT TISSUES: No significant abnormality noted.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: eval lung fields History: s/p LVAD Multiple chest tubes following sternotomy with no pneumothorax.Left lower lobe consolidation slightly worse.ET tube tip approximately 4 cm above the carina.Right jugular Swan-Ganz catheter tip in right main pulmonary artery.Right PICC, tip in the SVC.Unchanged LVAD and ICD.

Output: No pneumothorax. Stable support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: eval for interval change in IABP placement History: IABP Stable position of intra-aortic balloon pump with the marker in the proximal descending thoracic aorta. ICD atrial electrode is directed caudally.Cardiomegaly is unchanged. Mild vascular redistribution without interval edema. No significant pleural effusion or pneumothorax.

Output: Intra-aortic balloon pump in stable position.


Instruction: Generate impression based on medical findings.

Input: Male 62 years old; Reason: Increasing Oxygen requirement after Frey Procedure, please evaluate for collection. Low lung volumes with nonspecific bibasilar opacity which is likely a combination of small effusions and atelectasis. Heart size is stable.

Output: Non-specific bibasilar opacity which likely represents small effusions and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: 55yo M s/p swan placement, assess position History: as above Swan-Ganz catheter is within the RPA. Defibrillator lead terminates within the expected location the right ventricle. Low lung volumes makes detailed cardiopulmonary assessment difficult. Left costophrenic angles excluded from view. No focal lung consolidation or evidence of overt left-sided heart failure. Unchanged cardiomegaly. No pneumothorax.

Output: Low lung volumes makes detailed cardiopulmonary assessment difficult. Left costophrenic angles excluded from view. No focal lung consolidation or evidence of overt left-sided heart failure. Unchanged cardiomegaly. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: r/o aspiration pneumonia History: leukocytosis No significant cardiopulmonary abnormality.No acute abnormality.Cholecystectomy clips.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Reason: check ett placement History: intubated Endotracheal tube remains in good position. No acute cardiopulmonary findings.

Output: Stable line position. No acute cardiopulmonary findings.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: assess for pleural effusion History: SOB Right chest port has tip overlying the superior vena cava. Surgical clips project over the right neck and left axilla. Left basilar Pleurx catheter, unchanged.The cardiac mediastinal silhouette is unremarkable. Mild increase in right-sided pleural effusion with adjacent mild passive atelectasis. Stable left pleural effusion. No pneumothorax.

Output: Mild increase in right-sided pleural effusion with adjacent mild passive atelectasis. Stable trace left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male 83 years old with history of smoking and cough Stable cardiomediastinal silhouette. No focal consolidation. No pleural effusions or pneumothorax.

Output: Stable exam without interval acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: SOB evaluate for fluid overload. Motion artifact and patient rotation limit evaluation. Cardiomegaly is not appreciably changed. Hazy interstitial opacities, suggestive of edema. Mild posterior costophrenic angle blunting may represent trace pleural fluid or scarring.Thoracic kyphosis with severe degenerative changes of the spine.

Output: Limited evaluation. Interstitial abnormality suggestive of mild edema. Cardiomegaly is unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 43 years old.Reason: cardiopulmonary abnormalities? History: chest pain Borderline cardiomegaly but no focal opacity to suggest pneumonia. No evidence of significant edema. Small nonspecific faint nodular opacity overlying the right upper chest is presumably related to the cartilage involving the first rib but if the patient is high risk consider follow-up PA and lateral radiograph or noncontrast CT.

Output: Borderline cardiomegaly but no focal opacity to suggest pneumonia. No evidence of significant edema. Small nonspecific faint nodular opacity overlying the right upper chest is presumably related to the cartilage involving the first rib but if the patient is high risk consider follow-up PA and lateral radiograph or noncontrast CT.


Instruction: Generate impression based on medical findings.

Input: 54-year-old female with a history of MAI LUNGS AND PLEURA: Clearing of the previously noted ground grass glass and tree in bud opacities in the upper lobes and right middle lobe. Minimal scarring is identified at both bases. Peripheral areas of hypoattenuation and decreased vascularity are present posteriorly in the lower lobes and unchanged from the previous exam.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: 1. Clearing of the previously noted ground glass and tree in bud opacities in the upper lobes and right middle lobe. There is no evidence of pulmonary infection in this exam.2. Minimal residual focal subpleural areas of hypoattenuation and decreased vascularity posteriorly in the lower lobes, likely related to small airway disease.


Instruction: Generate impression based on medical findings.

Input: Age: 64 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p CABG ET tube with its tip approximately 4 cm above the carina.Right IJ Swan-Ganz with its tip in the right pulmonary artery.Chest/mediastinal tubes in place without evidence of a pneumothorax.Open sternotomy wound with drains and catheters in place.ECMO cannula in place.NG tube with its tip in the stomach.Decreased lung volumes with cardiac enlargement.Perihilar and basilar opacities compatible edema.Pleural effusions and basilar atelectasis.

Output: Postoperative chest with evidence of cardiomegaly, pleural effusions, and pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Reason: Pt w/ Hx of Necrotizing PNA p/w Hemoptysis History: hemoptysis Large left upper lobe cavitary lesion with adjacent pleural thickening and probably a small amount of fluid at the base of the cavity, consistent with necrotizing infection. Marked volume loss in the left hemithorax with mediastinal shift. Interstitial fibrosis and surgical staples at left base. No significant interval change allowing for slight differences in projection.

Output: Findings consistent with necrotizing infection in the left hemithorax. A CT scan has been performed and provides more detailed evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: r/o RCC mets History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality. No evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Recent thoracentesis, CHF "PEF", COPD, C/O SOB. Asymmetric lung volumes, right greater than left, unchanged. The left upper lobe is collapsed and there is segmental atelectasis in the right middle and upper lobes abutting the mediastinum. Near complete resolution of pleural fluid collections, unchanged compared to most recent prior study but improved from 5/9/2016. No pneumothorax or signs of CHF..

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Status post AV replacement. Right internal jugular Swan-Ganz catheter with tip in the right main pulmonary artery. Mediastinal drains are present. Endotracheal tube with tip at the carina. Postoperative changes of median sternotomy and aortic valve replacement.Cardiomediastinal silhouette is not significantly changed accounting for portable technique. No focal pulmonary consolidation. Streaky retrocardiac opacities likely subsegmental atelectasis. No large pleural effusions or pneumothorax.

Output: 1.Retrocardiac subsegmental atelectasis without focal consolidation.2.Endotracheal tube tip at carina. Findings text patient Dr. Schurle.


Instruction: Generate impression based on medical findings.

Input: Evaluate for obstruction or ileus, history of abdominal distention and tachypnea Suboptimal study secondary to patient motion artifact. Multiple dilated loops of small bowel (most pronounced in left upper quadrant where bowel measures up to 3.8 cm) with air and fecal material seen distally in colon. Vascular calcifications. Spinal degenerative disease. Please see same day chest radiography for additional findings.

Output: Findings suggesting ileus as described.Continued follow-up suggested to exclude partial or developing SBO.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old. Reason: IABP and femoral swan placement History: ADHF, as above Swan-Ganz catheter terminates over the right lung base and could be pulled back approximately 4 cm. Intra-aortic balloon pump positioning, unchanged. Right IJ line, unchanged. Cardiac leads, not substantially different. Port in mild pulmonary edema. Patchy left basilar opacities, likely atelectasis. No pneumothorax. Unchanged cardiomegaly.

Output: Swan-Ganz catheter terminates over the right lung base and could be pulled back approximately 4 cm.


Instruction: Generate impression based on medical findings.

Input: 69-year-old male intubated, concern and patient has bit tube. ET tube tip is approximately 15 cm above the carina, advanced on subsequent submitted radiograph.Enteric tube tip extends beyond the lower margin of the radiograph.Left chest tube in place.Spinal stabilization hardware is again noted.Heart size appears mildly enlarged.Interval decrease in moderate right pleural effusion with loculation of fluid along the major fissure.Lower zone predominant interstitial opacities with septal lines suggestive of mild CHF.Improved aeration of the left lung base.

Output: Interval decrease in moderate right pleural effusion. Mild CHF.


Instruction: Generate impression based on medical findings.

Input: 77-year-old male with history of known lymphoma CHEST:LUNGS AND PLEURA: Subcentimeter, nonspecific nodule in the right middle lobe image number 52, series number 5 small amount of left-sided pleural effusion and subsegmental atelectasis.Left lower lobe soft tissue density on image number 80, series number 3 abutting the left chest wall may represent atelectasis, however, an underlying neoplastic mass cannot be excluded. Correlation with at findings and/or biopsy is recommended. There is some associated nodularity in the left pleura.MEDIASTINUM AND HILA: Retrosternal goiter. Small nonenlarged mediastinal lymph nodes. An index posterior mediastinal node measures 1.6 x 1.2 cm image number 53, series number 3.CHEST WALL: Extension of a possible solid mass involving the left lower lobe as described above. Please refer to discussion in the lungs and pleural section.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter liver lesions are too small to accurate characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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 cystic sclerotic lesion involving the left sacrum.OTHER: No significant abnormality noted

Output: Left lateral soft tissue abutting the left chest wall. Correlation of CT findings with PET/CT and previous studies available. Biopsy may be an option, given the associated nodularity in the surrounding pleura on the left side.


Instruction: Generate impression based on medical findings.

Input: 69-year-old woman with history of lung cancer status post lobectomy, renal cell carcinoma status post right nephrectomy. Stable appearance of right hemithorax volume loss secondary to right upper lobectomy. Mild interstitial opacities, unchanged. No focal pulmonary opacity. No pleural effusions or pneumothorax.

Output: Stable post lobectomy appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Reason: assess for PNA, 30 yo male with left sided CP after cocaine use this AM History: left sided chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: Evaluate ETT placement - intubated for GI procedure in procedure suite - 77 yo F h/o COPD transferred from OSH with gram negative bacteremia c/f ascending cholangitis History: intubated for procedure ET tube tip approximately 5 cm above the carina.Streaky basilar opacities compatible with atelectasis and aspirated secretions.Vascular stent in the left superior mediastinum.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: IABP History: IABP Mild cardiomegaly status post sternotomy with chest tubes but no pneumothorax.Mild basilar edema and atelectasis are present postop, minimally worse.Status post extubation and NG tube removal.Left subclavian ICD, leads unchanged in position.Right jugular Swan-Ganz catheter tip in main pulmonary artery.IABP catheter distal tip 4.5 cm below the top of the aortic arch.

Output: Slight increase in basilar opacities following extubation, otherwise unchanged. IABP catheter tip 4.5 cm below the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: daily cxr History: n/a Mediastinal drains removed, with a right pleural drain still in place.Worsening basilar atelectasis, with stable pleural effusions.A Dobbhoff tube has its tip at the hemidiaphragm level and may be too high.Right jugular catheter, tip above the clavicle level.

Output: Increased basilar opacities. Mediastinal drains removed.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: s/p kidney pancreas transplant History: cough The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormality identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: 49 yo F w/ hgbSS admit with VOC increasing leukocytosis w/o source + VOC w/ failure to improve, please eval for infection or e/o ACS History: see above Stable cardiomegaly.Stable appearance of enlarged central pulmonary arteries.No new focal abnormalities, with no change in vascular congestion and edema.

Output: Pulmonary edema with no new focal pleural or parenchymal abnormalities.


Instruction: Generate impression based on medical findings.

Input: Right internal jugular catheter placement.VIEW: Chest AP (one view) 09/17/15, 1236 Right PICC and chest tube have been removed. Right internal jugular line tip is in superior vena cava. No pneumothorax is identified.Mediastinal mass is much smaller and measures approximately 8 cm in diameter. No focal lung opacity is identified. Cardiac silhouette size is normal.

Output: No evidence of complication after central line placement. Mediastinal mass smaller.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: s/p line placement History: line placement Heart size appears large but may be magnification artifact.No specific evidence of infection or edema.New left jugular catheter, tip in SVC.Stable left PICC and right jugular introducer.

Output: Uncomplicated left jugular catheter placement, with other catheters unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: swan., assess plcmt History: swan Cardiomegaly, and the suggestion of interstitial edema.Pulmonary vascular congestion noted.Right jugular Swan-Ganz catheter directed towards the right interlobar pulmonary artery.

Output: No change in Swan-Ganz position.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 89 years old.Aortic valve disease. Patchy lower lobe opacities which may represent atelectasis or scarring. No pleural effusion or pneumothorax. Mild cardiomegaly. Dense aortic calcification consistent with atherosclerosis. Mild diffuse osteopenia. Mild disc degeneration.

Output: No acute cardiopulmonary process. Mild cardiomegaly. Atherosclerosis.


Instruction: Generate impression based on medical findings.

Input: Age: 37 yearsGender: MaleReason for Study: Reason: r/o trauma History: pain There are decreased lung volumes.Mild nonspecific basilar opacities are compatible with atelectasis.Stable cardiomediastinal silhouette.No focal areas of consolidation.No pleural effusions.No evidence of a pneumothorax.No obvious rib fractures identified.

Output: Mild basilar atelectasis. No acute cardiopulmonary abnormalities identified.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: 24M sp MVC diffuse chest pain, eval for PTX or fx; unable to localize pain its "all over" History: as above No focal consolidation, pleural effusion or pneumothorax. The heart and mediastinal contours are within normal limits for size. The bones and upper abdomen are unremarkable.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: assess central line History: hypotensive on pressors Venous catheter has been removed. ICD unchanged. Stable cardiomegaly with pulmonary edema.

Output: Venous catheter has been removed.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old. Swan-Ganz catheter tip in the right descending pulmonary artery.Mainly interstitial opacity in the right upper and right lower lobes which may be due to edema.Unremarkable cardiac and mediastinal silhouette.

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


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.Reason: placement of PICC History: picc not functioning Unchanged subsegmental atelectasis left greater than right.Left jugular catheter tip in SVC.

Output: No change in basilar subsegmental atelectasis. No PICC identified despite the clinical history.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Fever question infiltrates Low lung volumes. Underinflation artifact. Hepatic and aortic arch calcifications.

Output: Low lung volumes, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: rule out pneumonia History: increase chest congestion Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Contrast material is seen in the thecal sac probably from a myelogram in the very remote past.

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


Instruction: Generate impression based on medical findings.

Input: 86-year-old female with history of right mandible carcinoma with reconstruction. Please evaluate. CHEST:LUNGS AND PLEURA: Focal area of linear atelectasis in the inferior upper lobe. No suspicious pulmonary nodules. No pleural effusion.MEDIASTINUM AND HILA: Moderate pericardial effusion. Mildly enlarged posterior tracheal lymph node as seen on image 14. Shotty mediastinal lymph nodes.CHEST WALL: Status post left mastectomy. Surgical clips are noted in the left axilla. Mildly enlarged axillary lymph nodes which are unchanged from prior exam.ABDOMEN:LIVER, BILIARY TRACT: No parenchymal lesions are identified in the liver. The gallbladder is normal in appearance. The hepatic vasculature is widely patent.SPLEEN: Splenic artery calcifications.ADRENAL GLANDS: Adrenal nodule that arises from the left limb of the left adrenal gland which measures 11 x 10 mm as seen on image 95, unchanged in appearance from prior scan on 1/25/2005.KIDNEYS, URETERS: Multiple cysts in the right kidney with the largest cyst arising from the superior pole of the right kidney unchanged in appearance. PANCREAS: Atrophic pancreas consistent with age.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Endotracheal tube. Interval advancement of nasogastric tube with the distal portion looped back upon itself in the epigastrium. Mild cardiomegaly. Bullous emphysema in the lung apices is again noted.

Output: Interval advancement of nasogastric tube; positioning of distal tip within proximal small bowel cannot be entirely excluded.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Shortness of breath. Rule out pneumothorax, evaluate pleural effusion. Unchanged opacification of the right hemithorax. Left lung nodules are better seen on recent CT. No evidence of pneumothorax.Cardiomediastinal silhouette is unchanged.

Output: Unchanged opacification of the right hemithorax. No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: Evalute ET tube position, evaluate interval change History: Intubated Line position stable. Low lung volumes. Basilar atelectasis as well as left retrocardiac opacity unchanged.Dobbhoff tube remains coiled within the gastric body and fundus.

Output: No interval change.


Instruction: Generate impression based on medical findings.

Input: Reason: eval vol status History: afib, vol overload Cardiomegaly with markedly enlarged central pulmonary arteries compatible with pulmonary hypertension.Interstitial opacity suggestive of edema with lower zone atelectasis and pleural effusions, not significantly changed.Catheter tip in the SVC.

Output: Findings compatible with pulmonary hypertension and CHF.


Instruction: Generate impression based on medical findings.

Input: Reason: Temp pacer History: Temp Pacer Temporary pacemaker from the IVC extending to the area of the lateral wall of the right ventricle.Skinfold on the left but no pneumothorax or other acute findings.Mild cardiomegaly and probable small pleural effusions.

Output: Pacemaker tip in the area of the right ventricle.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: eval ETT, lung fields History: s/p CABG Status post median sternotomy with chest tubes but no pneumothorax.Mild basilar atelectasis and edema with underlying scarring.ET tube tip approximately 5 cm above the carina.Right jugular introducer tip in right brachiocephalic vein.

Output: ET tube tip approximately 5 cm above the carina. Mild postop edema and basilar atelectasis but no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: eval lung fields History: s/p MVR Interval extubation. Otherwise tubes, unchanged. Low lung volumes. Mild pulmonary edema, slightly increased. Unchanged heart size. No pneumothorax or large pleural effusion.

Output: Interval extubation with low lung volumes and apparent increase in mild pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: eval for cause of sob History: sob. Hx of lung ca followed at osh. Crackles at l lung base 2 cm right upper lobe nodule highly suggestive of urinary lung cancer.Large lung volumes consistent with COPD.Heart mildly enlarged.

Output: Right upper lobe lung cancer. This is apparently known from an outside hospital.


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Reason: Please assess picc placement after re-adjustment History: New PICC line Interval readjustment of a right PICC which now terminates at the level of the right atrium. The remaining support devices are unchanged.No interval pneumothorax. Retrocardiac subsegmental atelectasis is stable. Gaseous distention of the stomach arch and visualized.

Output: Successful repositioning of the right PICC which terminates in the right atrium.


Instruction: Generate impression based on medical findings.

Input: Age: 70 yearsGender: FemaleReason for Study: Reason: decreased breath sounds, eval for effusion History: dyspnea Right central venous catheter with its tip in the SVC. Moderate cardiac enlargement.Course chronic appearing interstitial opacities similar to the prior exam.No new focal areas of consolidation.No large pleural effusions.Partially imaged IVC filter with multiple right upper quadrant surgical clips.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Encounter for screening for respiratory tuberculosis The cardiac contours are within normal limits.Lung volumes are normal. No abnormal focal lung parenchymal opacities. A right apical nodular opacity is considered artifactual, representing superimposition of the right second and right fifth ribs (key image).No pleural effusion or pneumothorax.

Output: No abnormal radiographic findings to suggest active infectious process


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Dissection, infiltrate? Chest pain. Upper normal heart size. Mild dilatation of the aortic root seen on recent CT is not readily visible by plain film technique. Remainder of the tortuous thoracic aorta appears of normal caliber and is not visibly enlarged, though assessment is limited by this technique. No mediastinal widening.Faint left seventh rib interspace nodular density. The lungs are otherwise clear Mild costophrenic angle blunting.Mild chronic mid thoracic anterior vertebral body wedging.

Output: 1. No mediastinal widening is appreciated. CTA may be obtained if there is continued clinical concern for dissection.2. Indeterminate posterior left lower lobe superior segment subpleural nodule described on CT from 7/15/2016 (level of the left seventh rib posteriorly, just medial to the scapula) not clearly visualized. This lesion is due for follow-up in 7/2017 but may be rescanned earlier if it correlates to the site of patient's pain.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: s/p R VATS, pleural Bx History: NA Stable position left port catheter. Interval placement right basilar chest tube directed toward the right cardiophrenic angle.Slight improved aeration on the right. Right sided opacities with mid to lower zone consolidation. Decreased amount of right pleural fluid with lucency at the right costophrenic angle, possibly from trace pneumothorax. No pneumothorax on the left.

Output: Slight improved aeration on the right and reduction of pleural fluid following right chest tube placement.


Instruction: Generate impression based on medical findings.

Input: 80 years old Female. Reason: SOB History: above. ICD leads projected to the area of the right atrial appendage and right ventricular apex, unchanged. Stable cardiomegaly. Elevated right hemidiaphragm with overlying subsegmental atelectasis. There is a new small right pleural effusion. No evidence of pneumothorax.

Output: New small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 78 year old female status post right mastectomy for right breast cancer. Patient presents with right chest wall pain. LUNGS AND PLEURA: Mild centrilobular emphysema. Calcified peripheral nodule which likely represents prior granulomatous infection. MEDIASTINUM AND HILA: Mild cardiomegaly. The pulmonary artery measures 3.5 cm in diameter which is suggestive of pulmonary arterial hypertension, however, stable from prior exam. Tortuous aorta.CHEST WALL: Dual chamber pacemaker is seen in the anterior right chest wall (not well evaluated on this exam). Please correlate if pacemaker could be a source of patient's pain. UPPER ABDOMEN: Simple cysts are seen in the upper pole of the left kidney.

Output: No evidence of metastatic disease in the chest or findings to explain the patient's chest wall pain (and see above). Please see nuclear study done on the same day for further correlation.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: eval lung fields History: s/p pericardial window 1 of the mediastinal/pericardial drains have been removed. Port catheter, unchanged. Persistent bibasilar opacities and pleural effusions. Unchanged cardiomegaly. No pneumothorax.

Output: 1 of the mediastinal/pericardial drains have been removed. Otherwise, no substantial difference.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: suspected pleural effusion History: shortness of breath Large left pleural effusion compressing left lung base.Mild right basilar subsegmental atelectasis.Heart size obscured by the effusion.

Output: Large left pleural effusion unknown etiology with basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male 80 years old Reason: Pneumo? s/p chest tube removal Interval removal of drain. Interval removal of the right central venous catheters. Aortic valve replacement again noted. Epicardial pacer leads remain in place.No pneumothorax. Small left pleural effusion. Streaky basilar opacities consistent with atelectasis, similar to prior.

Output: Interval removal of the drain and central venous catheters. Basilar atelectasis and small left pleural effusion, but no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: assess position of IABP and swan - s/p repositioning History: cardiogenic shock with swan and IABP in place IABP marker is not visualized on this study but seen on subsequent study. Dobbhoff tube projects over the mid esophagus. ET tube tip 8 cm above the carina. Swan-Ganz catheter tip is in the right lower lobar pulmonary artery. Remaining support devices unchanged.The cardiac silhouette is enlarged but stable.Bilateral pleural effusions have increased, right greater than left. Bilateral airspace opacities, left greater than right, appear stable from the prior examination.

Output: 1.IABP marker not visualized, but seen on subsequent examination. 2.ET tube tip appropriately positioned approximately 8 cm above the carina.3.Swan-Ganz catheter tip in the right lower lobar pulmonary artery.4.Dobbhoff tube tip in the mid esophagus.5.Stable edema with increasing effusions


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for infiltrate, pleural effusion History: volume overload Probable mild cardiomegaly with markedly under inflated lungs.No reliable evidence of pulmonary edema.Elevated right hemidiaphragm with mild atelectasis at the right base.PICC line tip in the left axilla.

Output: Markedly underinflated lungs with no reliable evidence of edema or visible effusion.


Instruction: Generate impression based on medical findings.

Input: 76 year old female for restaging lymphoma CHEST:LUNGS AND PLEURA: Index nodule in the right middle lobe is unchanged measuring 6 mm on image number 57, series number 5. Other subpleural nodules are also unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic cystic lesions are stable.SPLEEN: Small, nonspecific hypodense lesions in the, spleen, are minimally increased in number.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland mass measures 3.6 by 2.9 cm on image number 97, series number 3, stable.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index left para-aortic lymph node has increased in size and now measures 2.6 by 1.9 cm in image number 113, series number 3. Other retroperitoneal lymph nodes have also increased in size. Index mesenteric lymph node measures 2.2 by 1.3-cm, slightly smaller. Other mesenteric lymph nodes are stable to minimally increased in size..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: Indexed mesenteric lymph node is increased in size and now measures 2.1 x 1.6 cm image number 143, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Interval increase in the size of retroperitoneal and mesenteric lymph nodes. Interval minimal increase in the number or nonspecific, hypodense lesions in the spleen.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Low-grade fevers at night, SOB, new O2 requirement question pneumonia. Elevation of the right hemidiaphragm. In the obscured right costophrenic angle, new air lucencies are observed which may be areas of spared lung parenchyma with surrounding consolidation or potentially areas of cavitation/necrosis. The left lung is clear. Normal heart size.

Output: Indirect findings suggesting a necrotizing pneumonia in the right costophrenic angle, including multifocal lucent areas. This can be confirmed with PA and lateral chest radiographs. Follow-up PA and lateral chest radiographs recommended in 6 weeks.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: interval changes History: as above Decreased lung volumes with an increase in basilar opacities suggestive of edema and aspiration.Small pleural effusions are seen.Heart size slightly large, unchanged.IABP catheter tip 2 cm below the top of the aortic arch.IVC Swan-Ganz catheter, tip directed towards the left lower lung zone.ET tube tip approximately 2 cm above the carina.Right jugular catheter, tip at cavoatrial junction.Cardiac assist cannula unchanged.

Output: Unchanged support devices. Decreased lung volumes with increased pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Unknown, 36 years old.Reason: OG tube, ET tube placement History: OG/ET tube No significant cardiopulmonary abnormality.ET tube tip approximately 4 cm above the carina.An NG and esophageal probe terminates in the gastric fundus.Left jugular catheter, tip in SVC.Contrast material is seen in the renal collecting systems.

Output: No significant abnormality. ET tube tip approximately 4 cm above the carina. Esophageal probe terminates in the gastric fundus.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: Preop TECAB History: Preop TECAB The cardiomediastinal silhouette is normal. No pulmonary opacity, no pleural effusion, no pneumothorax. Tortuous aorta.

Output: No acute cardiopulmonary disease.


Instruction: Generate impression based on medical findings.

Input: Epilepsy, new onset dizziness. Check for pneumonia No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: assess new pacemaker, any pneumothorax s/p device placement History: new pacemaker Pacer leads terminating in expected location of the right atrial appendage and right ventricle. No pneumothorax. No new focal lung consolidation. Mild to moderate cardiomegaly again noted.

Output: No pneumothorax status post new pacemaker placement.


Instruction: Generate impression based on medical findings.

Input: 71-year-old male with history of thyroid cancer on therapy. CHEST:LUNGS AND PLEURA: Previously noted micronodules are unchanged (axial images 34, 52 and 53/103). New subcentimeter right lower lobe (axial image 48/103) and left lower lobe nodules (axial image 62/103). Small pleural-based nodule in the left lower lobe (axial image 34/103) is unchanged.Punctate centrilobular nodularity and bronchial wall thickening with scattered tree in bud opacities are slightly improved and may represent the sequela of aspiration. Debris is noted within the tracheal lumen.MEDIASTINUM AND HILA: Tracheostomy and AICD generator in the left chest wall are unchanged.Soft tissue prominence about the right sternoclavicular joint with apparent cortical disruption of the adjacent manubrium and clavicle is unchanged.Small mediastinal lymph nodes noted. Coronary artery calcifications evident.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple right renal hypoattenuating lesions are unchanged.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Two new nonspecific subcentimeter pulmonary nodules. Though these may be postinflammatory, continued follow up is recommended.Stable cortical destruction right sternoclavicular joint.


Instruction: Generate impression based on medical findings.

Input: Age: 73 yearsGender: FemaleReason for Study: Reason: intubation eval ett History: intubation ET tube with its tip at the orifice of the right mainstem bronchus.Left central venous catheter with its tip in the SVC.Stable cardiomediastinal silhouette with prominence of the pulmonary artery.Left basilar atelectasis and blunting of the left costophrenic angle compatible with small effusion and/or scarring.No focal areas of consolidation.Surgical clips in the right axilla

Output: ET tube with its tip at the orifice of the right mainstem bronchus. Recommend retraction.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: cp History: cp Central venous stents present. Right jugular dialysis catheter tip in high right atrium.Cardiomegaly. Minimal basilar interstitial opacity likely mild edema or atelectasis, improved from prior.Renal osteodystrophy.

Output: Cardiomegaly. Minimal basilar interstitial opacity likely mild edema or atelectasis, improved from prior.


Instruction: Generate impression based on medical findings.

Input: Reason: 62F s/p lap right hemicolectomy w/ fever, tachycardia History: Fever, tachycardia Unremarkable cardiac and mediastinal silhouette. Small lung volumes with streaky basilar opacities, compatible with subsegmental atelectasis.No specific evidence of pneumonia.

Output: Basilar atelectasis but no specific evidence of pneumonia.