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MIMIC-Impression-Dataset

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Impression
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MIMIC-CXR-JPG/2.0.0/files/p16142940/s50393233/0a846bcf-6ee0b9ca-0b1a2f7d-020ce96c-7dbda0fe.jpg
there is a persistent small to moderate right effusion with increasing airspace opacity more suggestive of atelectasis rather than an infectious process. linear opacity in the left lower lung likely reflects scarring. there is no evidence of pulmonary edema. the heart remains enlarged which may reflect cardiomegaly or pericardial effusion. clinical correlation is advised. no pneumothorax.
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right lower lobe focal consolidation consistent with pneumonia. followup chest radiograph is recommended in four weeks to document resolution.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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slightly increased size of the cardiomediastinal contour compared to the prior chest radiograph, and could be due to the presence of an increased pericardial effusion. unchanged appearance of small partially loculated left pleural effusion. increased interstitial opacities in the lung bases are similar compared to the prior chest ct, and again may reflect mild fluid overload or lymphangitic spread of tumor.
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relatively stable chest radiograph demonstrating mildly increased left basilar opacity the setting of lower lung volumes, probably representing atelectasis.
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bilateral lower lobe infiltrates/volume loss. this is increased compared to the study from the prior day
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in comparison with the study of , there again are relatively low lung volumes. central catheter again extends to the lower svc. cardio mediastinal silhouette is unchanged. there is mild indistinctness of pulmonary vessels, more prominent on the left, consistent with elevation of pulmonary venous pressure. more focal opacification is seen in the left lower zone. in the appropriate clinical setting, this would be worrisome for aspiration or infectious process. continued blunting of the costophrenic angles with basilar atelectasis. the minor fissure appears sharply defined on the current study.
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interval improvement of right basilar atelectasis and small pleural effusion. stable left basilar atelectasis and small pleural effusion. no new areas of consolidation suggestive of pneumonia.
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no acute intrathoracic process.
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in comparison with the study of , there has been substantial decrease in bilateral opacification, most likely representing improvement in the previous pulmonary edema. remainder of the study is essentially unchanged.
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the left subclavian infusion port ends in the mid svc. lungs clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
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no pneumonia. mild pulmonary vascular congestion. large hiatal hernia, increased from.
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no acute cardiopulmonary process.
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no evidence of acute cardiopulmonary disease.
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comparison to. no relevant change. the nasogastric tube has been removed. normal size of the cardiac silhouette. normal appearance of the lung parenchyma. no pneumonia, no pulmonary edema, no pleural effusions.
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no acute cardiopulmonary process.
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in comparison with the study of , the nasogastric tube extends to the distal antrum of the stomach. again there are low lung volumes, with little change in the pre-existing bilateral parenchymal opacities. in view of the clinical situation, aspiration would have to be considered.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality.
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no acute focal consolidation suggestive of pneumonia. small prominence, likely soft tissue in origin seen on the lateral view for which a <num>-week follow up is recommended.
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no definite acute cardiopulmonary process. slightly more conspicuous opacity at the left lung base, potentially due to atelectasis. two view chest xray may offer additional detail.
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minimal atelectasis in the lung bases but no evidence for pneumonia or pulmonary edema.
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normal chest radiograph.
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no acute cardiopulmonary process.
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in comparison with study of , there is little change in the cardiomediastinal silhouette and pacer leads. continued elevation of the right hemidiaphragmatic contour. opacification medially above the elevated hemidiaphragm most likely represents atelectatic changes. no definite acute focal pneumonia.
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no acute intrathoracic process.
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final radiograph demonstrating the tip of the nasogastric tube in the left upper quadrant, projecting over the stomach.
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highly limited exam by body habitus and underpenetration. severe cardiomegaly. no definite pulmonary pathology. please refer to subsequent ct abd/pelvis for additional details.
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no acute cardiopulmonary abnormality.
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right pleural effusion/possible pleural thickening with right lung atelectasis, possible right mid-to-lower lung consolidation. pulmonary edema and enlarged cardiac silhouette. slight blunting of the posterior left costophrenic angle may be due to a trace left pleural effusion. recommend followup to resolution to exclude an underlying neoplastic process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no definite pneumonia. if clinical suspicion persists, a repeat pa radiograph with improved inspiratory level may be helpful for more complete assessment of the lung bases.
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right upper lobe airspace consolidation, compatible with pneumonia in the proper clinical setting. recommend followup chest radiographs in <num> weeks following appropriate therapy to document resolution.
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in comparison with the study of , the patient has taken a better inspiration. continued enlargement of the cardiac silhouette with pacer lead extending to the apex of the right ventricle. no evidence of acute pneumonia or vascular congestion.
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no acute intrathoracic process.
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normal chest.
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no acute intrathoracic process.
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endotracheal tube terminates <num> cm above the carina. hazy opacities in the lungs, potentially combination of atelectasis in this supine patient although infection is possible.
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the lungs are clear without evidence of pneumonia.
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severe cardiomegaly and possible mild congestion.
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the tip of the swan-ganz catheter is positioned distally in the left descending pulmonary artery. recommend pulling back several centimeters to position the catheter closer to the hilum. results were discussed with (cardiothoracic surgery np) at on via telephone by dr at the time of the findings were discovered.
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an unusual <num> x <num> cm elliptical opacity projects over the ascending aorta on the lateral view. a similar abnormality, though less radiodense is seen on the lateral performed. this could be a benign lesion in the anterior segment of the right upper lobe or the mediastinum, alternatively it could be a soft tissue abnormality. to distinguish between the <num> i would recommend obtaining both routine and shallow oblique views. aside from of linear scar or platelike atelectasis in the lingula, lungs are clear. mediastinal and hilar contours are normal and the heart is not enlarged.
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patient is status post bronchoscopy with interval aeration of the left upper lung. multiple airspace opacities in the right lung are unchanged compared to prior study, likely representing pulmonary edema, however a superimposed pneumonia cannot be excluded. persistent retrocardiac opacity likely represents small left pleural effusion and atelectasis.
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no acute cardiopulmonary process, no effusion.
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clear lungs. please note that this radiographic study cannot evaluate for cholecystitis or stones as the reason for this examination indicates.
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two left-sided chest tubes and a left subclavian picc line remain in place. the patient is status post median sternotomy for cabg and mitral valve replacement. stable overall enlarged cardiac and mediastinal contours. there continues to be patchy opacity at the left base likely reflecting a compressive atelectasis, although pneumonia or aspiration cannot be entirely excluded. there is a lucency overlying the left lower lateral chest wall consistent with subcutaneous emphysema. left lateral pleural thickening is again noted. no pneumothorax. overall,aeration in the left lung has improved suggesting resolving edema.
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standard positions of the endotracheal and orogastric tubes. focal, somewhat linear opacities within both upper lobes which may be due to a chronic interstitial process. correlation with prior imaging is recommended. aspiration or infection, however, cannot be completely excluded. mild pulmonary vascular congestion in the setting of low lung volumes.
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no definite focal consolidation.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. previously seen metastatic lesions are not well seen on this exam.
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mild cardiomegaly with hilar congestion. pneumoperitoneum, possibly due to peritoneal dialysis catheter though clinical correlation is advised.
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no osseous abnormality within limits of plain radiography.
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no evidence of acute disease.
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apparent increase in size and number of pulmonary nodules. when clinically appropriate, correlation with chest ct is recommended. persistent but decreased hilar and subcarinal soft tissue fullness reflecting a probable reduction in lymphadenopathy.
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a small left pneumothorax is unchanged. a left thoracostomy tube is unchanged in position. mildly displaced left rib fractures are again demonstrated. there is no focal pulmonary consolidation. a small left pleural effusion is unchanged. the heart size is normal. the hilar and mediastinal contours are unchanged.
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there is moderate cardiomegaly. pacer leads are in standard position. there is no pneumothorax or pleural effusion. bibasilar atelectasis are minimal
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known pneumoperitoneum. the appearance of the lung parenchyma is unchanged. the monitoring and support devices are constant. unchanged normal size of the cardiac silhouette. retrocardiac atelectasis and minimal platelike atelectasis in the mid right lung zone. no overt pulmonary edema. no pneumonia, no larger pleural effusions.
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no evidence of acute disease.
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no evidence of acute cardiopulmonary process.
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multifocal pneumonia with persistent small bilateral pleural effusions. no significant change compared to recent prior.
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no acute cardiopulmonary process.
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pa and lateral chest compared to : substantial increase in size of the right hilus, right paratracheal tissue to the tracheobronchial angle and the mediastinum in the region of the ap window could be due to new adenopathy or progressive pulmonary hypertension. moderate cardiomegaly is slightly worse and there is new small pleural effusion on the left side. there are no lung findings to suggest pneumonia, but there may be several new small nodules in the left mid lung. ct scanning, even without contrast agent would be helpful in clarifying these new developments. dr and i discussed these findings, one minute after paging him at , one minute after recognition.
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new bibasilar opacities, likely a combination of bibasilar collapse and/or consolidation and small effusions. mild cardiomegaly, probably increased. upper zone redistribution and vascular plethora, suggestive of early chf.
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interval increase in the bilateral pleural effusions. superimposed infectious etiology cannot be excluded given the extent of the effusions. lateral view would be helpful if possible. stable right tracheal impression consistent with a right thyroid mass, unchanged compared to prior exams dating back to.
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in comparison with the study of , the patient has taken a better inspiration. cardiac silhouette is essentially within normal limits with now only mild elevation of pulmonary venous pressure. the hemidiaphragms are sharply seen, which could reflect decreasing pleural effusion, though some of the difference may merely be a more upright position of the patient. the right ij catheter is unchanged. the endotracheal tube and nasogastric tube have been removed.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary process.
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worsened cardiopulmonary findings. enteric tube tip is below diaphragm.
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chronic diffuse parenchymal abnormality predominantly characterized by marked bronchiectasis and scarring, most pronounced in the right upper lobe and left lung base, compatible with cystic fibrosis, and not substantially changed in the interval. no new areas of parenchymal opacification clearly identified.
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cardiomegaly with mild pulmonary edema is consistent with congestive heart failure. no pleural effusions.
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no acute cardiopulmonary process. interval resolution of focal consolidation in the left lower lobe since.
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-year-old female patient with sickle cell anemia, now recovering from episode of marked pulmonary congestion.
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no acute intrathoracic abnormalities identified.
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right picc line tip is at the level of right atrium and should be pulled back approximately <num> cm. heart size and mediastinum are stable. bibasal linear opacities are unchanged, most likely representing combination of chronic changes and lung infarct due to pulmonary embolism demonstrated on the previous chest ct.
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no acute intrathoracic process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no pneumonia.
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possible bronchitis.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormalities
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faint left perihilar opacity raises concern for infection. lymphomatous disease involvement or pulmonary hemorrhage would also be in the differential. recommend followup to resolution.
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ap chest compared to through at : very large chronic and recently growing multiloculated left pleural effusion has been partially evacuated, but substantial pleural abnormality persists, probably unrecoverable without surgical exploration. pulmonary vascular congestion in the right lung is stable. air collection at the base of the left hemithorax is a result of failure of the chronically collapsed left lower lung to reexpand. heart is very large and grossly unchanged.
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continued improvement in right lower lobe pneumonia, without radiographic evidence of heart failure.
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no new focal consolidation concerning for pneumonia. mild increase in the left pleural effusion. stable small right pleural effusion. unfamiliar appearance of the midline drain, which should be inspected for confirmation of position.
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no signs of pneumonia.
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no pneumothorax.
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no acute cardiopulmonary process.
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limited study due to low lung volumes and patient positioning. bibasilar atelectasis. no gross intrathoracic abnormality otherwise demonstrated however assessment of the left apex is markedly limited.
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no focal consolidation to suggest pneumonia. moderate cardiomegaly without overt pulmonary edema.
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moderate cardiomegaly with mild pulmonary vascular congestion. mild retrocardiac atelectasis. <num> rounded densities projecting over the upper abdomen on the lateral view only, likely external to the patient given their uniform appearance.
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moderate cardiomegaly, new since. crowding of bronchovascular structures without overt pulmonary edema.
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interval reaccumulation of large left pleural effusion. these findings were discovered at on and communicated with dr via telephone at
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the right upper chest pneumothorax is overall similar, though the right lung apex parenchymal tissue is better aerated than it was on the prior study. focal left midzone opacity is better seen than on the previous chest x-ray, but there is keeping with findings on the recent ct scan. possible minimal blunting of the left costophrenic angle, without gross left effusion.
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left lower lobe atelectasis. otherwise, no acute cardiopulmonary abnormality.
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no acute cardiopulmonary process.
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stable moderate cardiomegaly. no superimposed acute intrathoracic process.