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MIMIC-CXR-JPG/2.0.0/files/p13057576/s56617053/4cb540bf-163c0326-f0381330-0dd22a00-894090a7.jpg
no evidence of skeletal are pulmonary metastases. mild hyperinflation suggestive of a chronic process such as emphysema.
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cardiomediastinal silhouette is within normal limits. there are diffuse airspace opacities most prominent within the perihilar regions, right greater than left. this may represent focal pneumonia or aspiration. pulmonary edema is felt to be unlikely due to the normal vascular pedicle. followup to resolution of the opacities is recommended. there are no pneumothoraces or pleural effusions.
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compared to chest radiographs to. relatively mild bilateral infrahilar consolidation has persisted following substantial improvement from the appearance on. how much is atelectasis and how much residual pneumonia is radiographically indeterminate. upper lungs are clear. no appreciable pleural effusion. no pneumothorax. heart size normal. cardiopulmonary support devices unchanged in standard placements.
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no evidence of acute cardiopulmonary disease.
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there is a layering right effusion with associated patchy airspace disease in the right mid and lower lung which would be concerning for pneumonia given its focality. endotracheal tube, nasogastric tube and left subclavian central line are unchanged in position. overall cardiac and mediastinal contours are stable. no evidence of pulmonary edema. left lung is grossly clear.
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chronic bronchiectasis and sequela infection, but no gross change since the prior studies.
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no evidence of acute cardiopulmonary disease or rib fracture.
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no acute cardiopulmonary process.
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improving pulmonary edema. similar extent of pulmonary fibrosis.
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low lung volumes and patient rotation limits evaluation of cardiomediastinal contours. bibasilar opacities likely reflect atelectasis at, and remain more severe on the left than the right. adjacent small bilateral pleural effusions are present, but there is no visible pneumothorax.
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no acute cardiopulmonary process.
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in comparison with the study of , the monitoring and support devices are unchanged. cardiac silhouette remains at the upper limits of normal. again there are bilateral layering effusions, more prominent on the right, with underlying compressive atelectasis. some volume loss in the left lower lobe is again seen, as well as mild elevation in pulmonary venous pressure.
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small bilateral pleural effusions but no evidence of pneumonia.
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interval increase in right pleural effusion. stable right upper lobe area of bronchiectatic change. given the increasing pleural effusion and bronchiectatic change, this raises a question of a possible underlying malignancy. chest ct is indicated for further evaluation for malignancy.
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in comparison to chest radiograph, a confluent opacity in the right lung base has slightly worsened and may reflect an evolving post obstructive pneumonia in the setting of a known central right juxta hilar mass, more fully assessed by recent cta of. biapical opacities are similar to the prior radiograph and have been more fully assessed by ct. small right pleural effusion is noted.
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in comparison with the study of , the atelectatic changes at the left base medially have cleared. no evidence of acute pneumonia, vascular congestion, or pleural effusion.
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small right pleural effusion has slightly increased since
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no acute cardiopulmonary process.
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as compared to the previous radiograph, the known left pulmonary opacities are unchanged. on the right, opacities at the right lung apex and the right lung bases have minimally increased in extent and severity. constant is a retrocardiac atelectasis and a mildly enlarged cardiac silhouette. the monitoring and support devices are also unchanged. the dobhoff catheter is now in correct position.
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opacity within the right middle/lower lung base with some silhouetting of the right cardiac border is concerning for aspiration/pneumonia.
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no acute intrathoracic process. low lung volumes limits assessment.
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ap chest compared to : worsened aeration at the right lung base medially, probably atelectasis, has not improved since. pulmonary vascular engorgement and mediastinal venous distention accompany perihilar opacification, probably edema. supine positioning, however, may introduce serious artifacts to prevent side-by-side comparison. heart is moderately enlarged. no pneumothorax. right picc line ends low in the svc. feeding tube ends in the stomach.
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normal chest radiograph.
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no evidence of pulmonary edema. chronic interstitial fibrosis makes superimposed infection difficult to exclude. wet reading was relayed by dr to at the office of dr by phone at on.
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no significant interval change.
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no signs of pneumonia or chf.
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no acute cardiopulmonary process.
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no acute intrathoracic process.
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worsening edema.
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no acute cardiopulmonary process with no evidence of pneumonia. pleural scarring with fibrosis in the at left upper lung reflect healing of prior inflammatory process.
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as compared to the previous radiograph, the patient has received a nasogastric tube. the course of the tube is unremarkable. the tip projects over the cavoatrial junction and the device should be advanced by approximately <num> cm. the right central venous access line is unchanged. the large right apical mass is constant in size and morphology. no evidence of pneumonia. no pulmonary edema.
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no acute intrathoracic process.
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heterogeneous right infrahilar opacity may represent developing pneumonia or aspiration. correlate with clinical signs and symptoms.
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mild cardiac enlargement, otherwise normal chest.
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low lung volumes with probable bibasilar atelectasis.
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the previous radiograph, there is a minimal increase in extent of the bilateral pleural effusions. otherwise, the radiograph is unchanged. moderate cardiomegaly. bilateral areas of atelectasis. moderate pulmonary edema. no pneumonia. no pneumothorax.
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compared to chest radiographs through. lung volumes have improved, small right pleural effusion and right basal atelectasis persists. no pulmonary edema. normal appearance to the postoperative cardiomediastinal silhouette. healed fracture, antero lateral right fourth rib should not be mistaken for a lung nodule. transvenous right ventricular pacer defibrillator lead in standard placement.
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mild pulmonary vascular congestion. overall, no substantial change since.
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moderate cardiac enlargement is stable, but pulmonary and mediastinal vasculature are normal and there is no edema. mild heterogeneous opacification in the retro cardiac left lower lobe could be pneumonia but is more likely atelectasis. pleural effusion on the left is small if any. no pneumothorax. dual channel central venous catheter ends in the right atrium.
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no acute cardiopulmonary process. free intraperitoneal air compatible with recent surgery.
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no acute cardiopulmonary process.
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no acute intrathoracic process.
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no radiographic evidence of pneumonia.
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no acute intrathoracic process. presumed gallstone noted in the right upper quadrant.
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limited examination, but no definite evidence of acute disease.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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ap chest compared to through at : following placement of the right pigtail drain, there has been a substantial improvement in the volume of previously large right pleural effusion which was responsible for near- complete collapse of the right lung. right upper lobe is now well aerated. atelectasis is limited to the lower and some of the right middle lobe. a small volume of air is present at the apex and at the right lung base medially. indwelling basal pleural drain unchanged in position. small-to-moderate left pleural effusion stable. left upper lung clear. cardiac silhouette hard to assess because of adjacent pleural effusion.
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endotracheal tube tip is <num> cm above the carina. the feeding tube tip is now pointing cephalad but within the fundus of the stomach. there is tortuosity of the thoracic aorta. there is no focal consolidation. there is minimal prominence of the pulmonary interstitial markings without pulmonary edema. no pleural effusions or pneumothoraces are seen.
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mildly engorged central pulmonary vasculature without overt pulmonary edema. no definite focal consolidation.
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no pneumonia or edema. tiny right pleural effusion, improved from.
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limited study without sefinite signs of pneumonia or overt chf. please refer to subsequent cta chest for additional details.
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in comparison with the study of , the monitoring and support devices are unchanged. opacification at the right base is unchanged, again consistent with collapse of the middle and lower lobes. the left lung remains clear.
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no acute intrathoracic process. no pneumothorax.
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mild pulmonary edema and trace effusions, smaller when compared to.
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normal chest radiographs. no pneumonia.
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low lung volumes with bibasilar atelectasis.
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possible slight blunting of both costophrenic angles posteriorly, which could be new. otherwise, i doubt significant interval change. no displaced rib fracture detected. please see comment above.
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comparison to. stable severity of moderate pulmonary edema with additional moderate cardiomegaly and a likely small left pleural effusion. no right pleural effusion. areas of subpleural fibrosis at the level of the right upper lobe.
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in comparison with the study of , there is no evidence of acute consolidation at this time. no vascular congestion, pleural effusion, or cardiomegaly.
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compared to chest radiographs through at. mild pulmonary edema has worsened, accompanied by increasing moderate right pleural effusion. small left pleural effusion is stable. severe cardiomegaly chronic and unchanged. no pneumothorax. lines and tubes in standard placements.
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no acute cardiopulmonary process.
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biventricular pacemaker with leads identified in the right atrium and right ventricle. moderate bilateral pleural effusions.
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mild pulmonary edema, moderate cardiomegaly and mediastinal venous engorgement have improved since. small left pneumothorax is smaller. left pleural effusion is minimal if any. <num> left pleural drains still in place. volume of subcutaneous emphysema in left chest wall has decreased. no pneumothorax.
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no acute cardiopulmonary abnormality.
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a central venous catheter is not seen.
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central pulmonary vascular congestion with mild interstitial edema. new left basilar opacity with small left pleural effusion, possibly representing a small consolidation.
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left lower lobe is airless, and the mediastinum shifted mildly to the left. this indicates a large component of atelectasis, although pneumonia is not excluded. left pleural effusion is small. a small region of peribronchial opacification in the right lower lobe could be due to aspiration or early pneumonia. heart size is normal. no pneumothorax.
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no evidence of acute cardiopulmonary process.
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pa and lateral chest compared to : right internal jugular line is new, ending in the low svc. no pneumothorax, pleural effusion or mediastinal widening. borderline cardiomegaly stable. upper lobe redirection of pulmonary blood flow is mild but there is no pulmonary edema or pleural effusion and no focal pulmonary abnormality to suggest infection.
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mild cardiac enlargement for which clinical correlation is advised. bibasilar atelectasis without convincing evidence for pneumonia.
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no acute cardiopulmonary process.
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comparison to. no relevant change. normal size of the cardiac silhouette. normal appearance of the cardiac silhouette. no pleural effusions. no pneumonia, no pulmonary edema.
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comparison to. no relevant change. the lung volumes are large, the lateral radiograph show signs of overinflation. no pneumonia, no pleural effusions, no pulmonary edema. normal size of the cardiac silhouette. no pneumothorax.
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there are persistent low lung volumes. bibasilar atelectasis larger on the left side have minimally increased. cardiac size is normal. there is no pneumothorax or pleural effusion. catheter projects in the left upper quadrant of the abdomen
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there are numerous round opacities scattered throughout bilateral lungs, consistent with pulmonary metastasis, larger or new compared to.
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in comparison with study of , there is little change and no evidence of acute cardiopulmonary disease. no pneumonia, vascular congestion, or pleural effusion. again, there is an impression on the right side of the lower cervical trachea, raising the possibility of a thyroid mass.
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unchanged cardiomegaly and thoracic aortic tortuosity. improved interstitial abnormality when compared to prior radiographs.
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ap chest compared to : tip of the new left pic line can be traced as far as the low svc, but the tip is indistinct. nasogastric tube ends in the stomach, which is the only region of the intestinal tract not severely distended with gas and fluid. there is no free subdiaphragmatic gas. aside from the expected bibasilar atelectasis, relatively mild on the right. lungs are clear. the heart is normal size.
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no acute intrathoracic process.
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no acute cardiopulmonary process.
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in comparison with the study of , the dobbhoff tube has been removed. again there are diffuse bilateral pulmonary opacifications, especially in the mid zones bilaterally, consistent with recurrent pneumonia. retrocardiac opacification again is consistent with volume loss in the left lower lobe. bilateral pleural effusions are again seen. no evidence of acute collapse or shift of the mediastinal structures.
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no acute cardiopulmonary process.
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pulmonary edema. opacity in the right lower lobe may represent pneumonia and/or aspiration in correct clinical setting.
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unchanged position of the left pigtail catheter and of the cervical tip of the endotracheal tube. no relevant change in appearance of the left lung.
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no acute cardiopulmonary process.
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compared to chest radiographs since , most recent. lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal. no evidence of pneumonia.
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no acute cardiopulmonary abnormality.
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in comparison to prior radiograph of <num> day earlier, bibasilar atelectasis has slightly improved in the interval. small bilateral pleural effusions persist.
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cardiomegaly without superimposed acute cardiopulmonary process.
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no evidence of free abdominal air on upright chest examination.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, no relevant change is seen. normal lung volumes. normal appearance of the cardiac silhouette and of the hilar and mediastinal structures. no pleural effusions. no pneumonia, no pulmonary edema.
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in comparison with the study of , there has been complete clearing of the right upper lobe pneumonia. otherwise little change.
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in comparison with study of , there is little interval change. the cardiac silhouette remains enlarged with minimal if any vascular congestion. no acute focal pneumonia. there may be small pleural effusions on both sides.
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pa and lateral chest compared to : the extent of consolidation in the lingula has decreased. some of this may be due to clearing and some to atelectasis. there is no evidence of bronchial obstruction or central adenopathy and no pleural effusion. right lung is entirely clear. heart is not enlarged.
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interval additional progression of pulmonary edema is demonstrated associated with large, loculated pleural effusions. vertebroplasty is re- demonstrated.
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marked cardiomegaly, considerably increased compared with. is there concern for pericardial effusion? small bilateral effusions, with bibasilar patchy opacities, unchanged compared with at.
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moderate bibasilar atelectasis with low lung volumes.