wrong prediction of simple_integration.txt

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equivocal soft tissue density in the retro ##st ##er ##nal region which may reflect prominent outflow tract or alternatively soft tissue in the prev ##ascular space . chest ct could further assess .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little overall change in the appearance of the subd ##ia ##ph ##ragm ##atic gas consistent with pneum ##oper ##itoneum . no evidence of acute pneumonia or vascular congestion .
pred: 3. correct value: 0
no acute cardiopulmonary pathology .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
significantly aneurysm ##al and tort ##uous thoracic aorta . small left pleural effusion .
pred: 2. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are clear . there is no pleural effusion or pneumothorax . lateral view demonstrate questionable spi ##cu ##lated nodule , 8 mm in diameter , potentially summation of shadow ##s . reass ##ess ##ment with lateral oblique views is recommended no evidence of active or chronic tuberculosis is present .
pred: 3. correct value: 2
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality identified .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there again is substantial enlargement of the cardiac sil ##hou ##ette with worsening pulmonary vascular congestion . no definite acute focal pneumonia , though this would be difficult to unequiv ##ocally exclude in the appropriate clinical setting , especially in the absence of a lateral view . monitoring and support devices are unchanged .
pred: 3. correct value: 1
of acute cardiopulmonary process .
pred: 1. correct value: 0
1 . no focal pneumonia . 2 . small left pleural effusion and ate ##lec ##ta ##sis .
pred: 3. correct value: 0
previous peri ##bronchial infiltration in the right upper lung and both lung bases has resolved . this is probably a non ##ba ##ct ##eria ##l pneumonia . heart size is top normal , unchanged . lungs are essentially clear . there is no pleural abnormality or evidence of central lymph node enlargement .
pred: 3. correct value: 2
as compared to the previous radiograph , the left central venous access line has been removed . there is unchanged evidence of diaphragmatic elevation on the left as well as of moderate cardio ##me ##gal ##y . otherwise the postoperative appearance of the left lung is normal . no pulmonary edema . no pneumonia . no pleural effusion ##s seen on the lateral radiograph .
pred: 3. correct value: 1
strong clinical concern for rib fracture , a dedicated rib series is recommended to further assess .
pred: 1. correct value: 0
copd left lower lobe pneumonia . recommendation ( s ) : recommend follow up chest radiographs notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the _ _ _ _ _ _ at 2 : 00 pm , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
compared to the prior chest radiographs , since _ _ _ , most recently _ _ _ . lung volumes remain quite low . mild pulmonary edema has worsened . heart size top - normal . no pneumothorax or appreciable pleural effusion . et tube , now 2 . 5 cm from the car ##ina with the chin in neutral or slight flexion should not be advanced further . esophageal drainage tube passes into the stomach and out of view .
pred: 3. correct value: 1
focal asymmetric increase in density of the left apex compared to prior studies . recommend apical lord ##otic view to differentiate between pulmonary abnormality ( lung nodule or focal consolidation ) and a summation of normal , overlying structures . notification : initial resident interpretation of absence of pneumonia was discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 12 : 55 pm , 1 minutes after discovery of the findings . the focal asymmetrical left apical density was discovered upon subsequent attending review and these results were entered into the online reporting database .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , with 3 chest tubes on water seal there is no convincing evidence of pneumothorax . increased opac ##ification at the left base is again consistent with volume loss in the lower lobe and pleural effusion . in view of the oblique position of the patient , it is difficult to determine whether there is mediastinal shift to the left . the right lung is essentially clear at this time .
pred: 3. correct value: 0
substantial progression of opac ##ification at both lower lobes confirms the impression reported on yes ##ter ##day ' s radiograph of likely aspiration pneumonia , probably accompanied by mild pulmonary edema . et tube is in standard placement . hyper ##infl ##ation indicates severe emphysema . dr . _ _ _ was page ##d to report these findings .
pred: 3. correct value: 0
no pen ##um ##onia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
bilateral basal small bore pleural catheter is unchanged in position since at least _ _ _ . small pleural effusion ##s persist . no pneumothorax . severe cardio ##me ##gal ##y is stable . areas of consolidation at both lung bases in the axillary portion of the left lung have worsened since _ _ _ . i suspect at least one of these is pneumonia . hemodialysis catheter ends in the mid and low right atrium . no pneumothorax .
pred: 3. correct value: 1
increased interstitial marking ##s could reflect mild pulmonary vascular congestion . there is no evidence of pneumonia .
pred: 1. correct value: 0
moderate bilateral pneumothorax has increased since earlier in the day , resulting in moderate bib ##asi ##la ##r ate ##lec ##ta ##sis . details of a caregiver notification are given below . no appreciable pleural effusion . heart size normal .
pred: 3. correct value: 2
low lung volumes . no radiographic evidence for pneumonia .
pred: 1. correct value: 0
mild pulmonary edema has continued to improve . small right pleural effusion persists . moderate - to - severe cardio ##me ##gal ##y is chronic . the contour of the thrombo ##se ##d aortic pseudo ##ane ##urys ##m is unchanged . left pic line ends at the origin of the sv ##c . small left pleural effusion is presumed . no pneumothorax . patient has had proximal resection of the right humerus .
pred: 3. correct value: 1
as compared to _ _ _ , stable cardio ##me ##gal ##y and tort ##uo ##si ##ty of the thoracic aorta are present in this patient status post previous coronary bypass surgery . lungs and pleural surfaces are grossly clear .
pred: 2. correct value: 1
hyper ##infl ##ation without acute cardiopulmonary process .
pred: 1. correct value: 0
copd . improved right pneumonia . small bilateral effusion ##s
pred: 1. correct value: 0
the appropriate clinical setting . trace bilateral pleural effusion ##s .
pred: 1. correct value: 0
partial exclusion of the right cp angle .
pred: 1. correct value: 0
no definite acute process but apparent increase in infra ##hi ##la ##r density suggested only by the lateral view . short - term follow - up radiographs may be helpful to assess further .
pred: 1. correct value: 0
comparison _ _ _ . the left chest tube is in unchanged position . the left lung is substantially better ventilated than on the previous image . however , the left lung changes remain substantial . no change in appearance of the normal right lung . stable normal appearance of the right heart border .
pred: 1. correct value: 0
findings most consistent with mild interstitial pulmonary edema .
pred: 1. correct value: 0
impression small to moderate right pneumothorax , with apical , basal , and posterior components has not changed appreci ##ably since _ _ _ . 2 right pleural drainage tubes are unchanged in their respective positions . mild right basal ate ##lec ##ta ##sis is unchanged . heart is normal size and the mediastin ##um is midline . left lung is hyper ##infl ##ated but clear .
pred: 3. correct value: 0
bronchi ##ect ##asis . small right lower lobe pneumonia .
pred: 1. correct value: 0
one right thorac ##ostomy tube has been removed ; apical and basilar tubes remain . a moderate right pleural effusion is again seen . there is persistent edema and ate ##lec ##ta ##sis at the right base . no pneumothorax is detected . a small amount of subcutaneous emphysema at the thorac ##ostomy tube insertion site is unchanged . mild cardio ##me ##gal ##y is stable .
pred: 3. correct value: 1
amount of air within the right ple ##ura compatible with a small hydro ##pn ##eu ##mo ##th ##orax .
pred: 1. correct value: 0
pneumothorax .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
increased density at the right lung base with posterior - lateral correlate which could represent ate ##lec ##ta ##sis , aspiration or pneumonia .
pred: 1. correct value: 0
effusion ##s and bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 3
no acute cardiopulmonary process . if high clinical concern for pulmonary lesion , chest ct is more sensitive in detecting subtle lesions .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . the patient has been ext ##ubated and the feeding tube was removed . the right internal jugular vein catheter is in stable position . there is no evidence of a pneumothorax . the postoperative pneum ##o peric ##ardium has resolved . no larger pleural effusion ##s . mild bilateral areas of ate ##lec ##ta ##sis .
pred: 3. correct value: 0
is recommended to aid in differentiation between pneumonia and effusion . when lateral is obtained please attempt to have patient as upright as possible with arms extended .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
no focal consolidation ##s concerning for pneumonia identified . stable 7 mm nodule in the mid right lung , given differences in acquisition technique .
pred: 1. correct value: 0
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary abnormality demonstrated .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
uncertain findings regarding pneumonia , bronchi ##ect ##asis , and possible aortic dissection or aggressive mediastinal adeno ##path ##y warrant prompt ct scanning .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
definite evidence for acute disease .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of cav ##itary lesion in the left lower chest . improved left basilar consolidation . worsened right basilar infiltrate , with increasing consolidation . small pleural effusion ##s .
pred: 3. correct value: 0
feeding tube tip in the proximal stomach
pred: 1. correct value: 0
low lung volumes with patchy bib ##asi ##la ##r air ##space opac ##ities , wor ##ris ##ome for pneumonia .
pred: 1. correct value: 0
compared to prior chest radiographs , _ _ _ through _ _ _ at 04 : 26 . mild cardio ##me ##gal ##y has improved and moderate cardio ##me ##gal ##y has decreased . small right pleural effusion stable . no pneumothorax . right internal jugular introduce ##r ends at the thoracic inlet . et tube and trans ##esophageal drainage tube in standard placement ##s respectively .
pred: 3. correct value: 1
there is no notable interval change . left lung base consolidation is chronic , probably related to scoliosis .
pred: 1. correct value: 0
normal chest radiographs .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormalities identified .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the left hemi ##di ##aph ##ragm is now sharply seen , consistent with improving ate ##lec ##ta ##sis or consolidation at the left base . cardiac sil ##hou ##ette remains within normal limits and there is no evidence of vascular congestion or pleural effusion . trache ##ostomy tube remains in place . right subcl ##avi ##an pic ##c line again extends only as far as the junction with the superior vena cava .
pred: 3. correct value: 2
multifocal pneumonia . edema nearly resolved .
pred: 1. correct value: 0
feeding tube with a wire style ##t in place ends in the region of the pyl ##or ##us and may be post - pylori ##c . other findings described on subsequent chest radiographs available at the time of this review .
pred: 3. correct value: 0
known small left pneumothorax is not clearly identified . small left effusion with adjacent ate ##lec ##ta ##sis has markedly increased . there are low lung volumes . cardiac size cannot be evaluated .
pred: 3. correct value: 1
no pneumonia detected .
pred: 1. correct value: 0
there is cardio ##me ##gal ##y . there is no chf , pneumothorax or consolidation . there is extensive arthrop ##athy in the right shoulder and degenerative changes are present in the left shoulder . degenerative change and scoliosis are present in the spine .
pred: 3. correct value: 1
left lower lobe has been intermittent ##ly consolidated , partially reex ##pan ##ded on _ _ _ , subsequently consolidated again . whether this is due to pneumonia or collapse is radiographic ##ally indeterminate . most of the increased radio ##pa ##ci ##ty throughout the right lung is due to a combination of edema and pleural effusion on that side . small amount of pleural effusion is present on the left . left supra ##cl ##avi ##cu ##la ##r central venous catheters all end in the mid - to - low sv ##c . no pneumothorax .
pred: 3. correct value: 0
no pneumonia
pred: 1. correct value: 0
two frontal and two lateral views were performed . both frontal views suggest left lower lobe pneumonia , corroborated on just one of the lateral views , taken at lower lung volumes . i think the finding should be considered in either recent aspiration or pneumonia , unless excluded clinically . findings were discussed by telephone with dr . _ _ _ at 11 : 10 a . m . right lung is clear . there is no pleural abnormality , hil ##ar and cardio ##medi ##astin ##al sil ##hou ##ettes are unremarkable . a pace ##r device in the left anterior chest wall send ##s a filamentous lead to the left lower neck .
pred: 3. correct value: 0
in comparison with study of _ _ _ , the cardiac sil ##hou ##ette remains at the upper limits of normal in size . again there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 1
pleural effusion ##s .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
on _ _ _ patient was in mild pulmonary edema with mild cardio ##me ##gal ##y . today although heart has returned to normal size , there has been any increase in pulmonary vascular prof ##usion since _ _ _ and there new small pleural effusion ##s . although role this is not pulmonary edema , it may reflect early cardiac decompens ##ation . very heavy mitral annulus calcification may predispose the patient to mitral regurgitation . no pneumonia is seen .
pred: 3. correct value: 1
spi ##cu ##lated right upper lobe mass .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
1 . lungs are relatively well inflated with no focal air ##space consolidation to suggest pneumonia . there are some stre ##ak ##y linear opac ##ities in the left cost ##oph ##ren ##ic sulcus which may reflect subs ##eg ##mental ate ##lec ##ta ##sis or post - inflammatory scarring . there is no evidence of pulmonary edema . more focal nodular appearance to the right hil ##um may reflect vascular ##ity and overlapping shadow ##s , but this can be better assessed on followup imaging . the cardiac contour is within normal limits . no acute bony abnormality appreciated .
pred: 3. correct value: 2
in comparison with the earlier study of this date , the endotracheal tube remains well positioned , approximately 5 cm above the car ##ina . other monitoring and support devices are unchanged . continued enlargement of the cardiac sil ##hou ##ette and without definite vascular congestion . ate ##lec ##ta ##tic changes are seen at the left base and there is a there is blunt ##ing of the cost ##oph ##ren ##ic angles bilaterally
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there again are relatively low lung volumes that accent ##uate the transverse diameter of the heart . mild ate ##lec ##ta ##tic changes at the bases with blunt ##ing of the cost ##oph ##ren ##ic angles . however , no evidence of vascular congestion or acute focal pneumonia .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
low lung volumes without definite acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is again by basilar opac ##ification consistent with pleural effusion ##s and ate ##lec ##ta ##sis . the smaller collection posterior to the stern ##um is again seen , most likely related to the recent surgery . no acute focal pneumonia or vascular congestion .
pred: 3. correct value: 0
1 . new retro ##car ##di ##ac opac ##ity , most consistent with pneumonia given the clinical history of new - onset fever . 2 . stable enlarged heart and prominent pulmonary vasculature . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ _ _ _ , the referring provider team , on the telephone on _ _ _ at 3 : 42 pm , 5 minutes after discovery of the findings .
pred: 1. correct value: 3
comparison to _ _ _ . no relevant change is noted . signs of mild over ##infl ##ation . no evidence of pneumonia . no pulmonary edema , no pleural effusion ##s . no pneumothorax . normal size of the heart . the right pector ##al port - a - cath is in stable correct position .
pred: 3. correct value: 2
do ##bh ##off tube tip isi ##n the stomach . this is limited study due to the position of the patient . no interval change from prior study .
pred: 1. correct value: 0
1 . interval worsening of multifocal pneumonia . 2 . interval worsening of concurrent mild edema and bilateral right greater than left small pleural effusion ##s .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous image , no relevant change is seen . retro ##car ##di ##ac ate ##lec ##ta ##sis . no pneumonia . normal size of the cardiac sil ##hou ##ette . the course of the left pic ##c line is unchanged . the tip continues to project over the confluence of the superior vena cava and the brach ##io ##cephal ##ic vein .
pred: 1. correct value: 2
as compared to the previous radiograph , the parenchymal opac ##ities at the right lung base and in the mid right lung are constant in appearance . stability in extent and morphology suggests scarring rather than inflammation or infection . the extent of the partly organized right pleural fluid is constant . no new opac ##ities seen on the left . unchanged moderate cardio ##me ##gal ##y and mild tort ##uo ##si ##ty of the thoracic aorta .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is again substantial elevation of the right hemi ##di ##aph ##ragm ##atic contour . mild ate ##lec ##ta ##tic changes above the elevated hemi ##di ##aph ##ragm are suggested on the lateral view . no evidence of acute pneumonia or vascular congestion .
pred: 3. correct value: 0
no displaced rib fracture is seen . however this study is not tailored for the evaluation of rib fractures . if there is continued clinical concern , please obtain a dedicated rib series with skin marker indicating the location of pain .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary abnormality . known right lower lung mass is seen , but will be better evaluated on the ordered same - day ct .
pred: 1. correct value: 0
chronic left fis ##su ##ral , pleural abnormality . either progression of mild interstitial abnormality or new bronchial inflammation .
pred: 3. correct value: 0
residual edema or pneumonia , including aspiration . dr . _ _ _ _ _ _ the findings with icu team by phone at 9 : 30 ##am on _ _ _ .
pred: 1. correct value: 0
persistent multifocal opac ##ities bilaterally , improved since _ _ _ , but stable compared to the ct on _ _ _ .
pred: 3. correct value: 0
no pneumothorax . known trace pericardial effusion is better assessed on the concurrent cta chest .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . normal size of the cardiac sil ##hou ##ette with minimally wide ##ned mediastin ##um , explained by the lymph nodes seen on the ct examination from _ _ _ . no evidence of parenchymal abnormalities , notably no evidence of pneumonia . no pleural effusion ##s .
pred: 3. correct value: 2
comparison to _ _ _ . no relevant change . moderate cardio ##me ##gal ##y . minimal right and moderate left pleural effusion with subsequent areas of ate ##lec ##ta ##sis . unchanged stern ##al wires and monitoring and support devices . mild pulmonary edema . unchanged alignment of the stern ##al wires .
pred: 3. correct value: 1
newly placed left pic ##c line . the course of the line is unremarkable , the tip of the line projects over the mid sv ##c . no complications , notably no pneumothorax .
pred: 2. correct value: 0
pneumonia .
pred: 1. correct value: 0
1 . new large left middle and lower lung zone opac ##ity , most consistent with pneumonia . a component of pleural fluid is difficult to completely exclude . recommend follow - up to resolution to exclude an underlying ##ma ##ss . 2 . smaller opac ##ity at the right base may represent ate ##lec ##ta ##sis or second focus of pneumonia . 3 . apparent wide ##ning of the mediastin ##um may be related to the ap technique and patient rotation . recommend a repeat pa and lateral radiograph when the patient is more clinically stable , if high clinical concern for acute mediastinal / aortic process , ct is more sensitive . results were discussed with dr . _ _ _ at 10 : 15 a . m . on _ _ _ via telephone by dr . _ _ _ at the time the findings were discovered .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
clear lungs . no displaced rib fracture is identified .
pred: 1. correct value: 0
extensive left pleural thickening is long ##standing . pleural abnormality at the base of the right hemi ##th ##orax is less extensive , but equally chronic . whether there is any layer ##ing pleural effusion is radiographic ##ally indeterminate . the previous heterogeneous opac ##ification at both lung bases on _ _ _ has improved , and is therefore not pneumonia . this could have been either ate ##lec ##ta ##sis , recent aspiration or early dependent edema . heart is normal size . trans ##ven ##ous right atrial and right ventricular pace ##r leads are as far as one can tell on the frontal view alone , unchanged since at least _ _ _ . there is no pulmonary edema . no pneumothorax .
pred: 3. correct value: 0
as compared to the previous radiograph , the left - sided pig ##tail catheter is in unchanged position . minimal decrease in extent of the pre - existing left pleural effusion . the retro ##car ##di ##ac ate ##lec ##ta ##sis is constant . no pneumothorax . normal appearance of the heart and of the right lung .
pred: 3. correct value: 2
no evidence of pneumonia .
pred: 1. correct value: 0
heart size is top - normal . mediastin ##um is unremarkable . lungs are essentially clear . no pleural effusion or pneumothorax is seen . pacemaker leads terminate in the expected position . no evidence of acute process such is edema or pneumonia demonstrated .
pred: 2. correct value: 1
small right apical pneumothorax is new since _ _ _ presumably following thorac ##ente ##sis , with placement of a mid chest tube and basal tube in the right hemi ##th ##orax . right middle and lower lobe previously collapsed are beginning to re - expand . left lung is clear of consolidation but has new bands of subs ##eg ##mental ate ##lec ##ta ##sis and new pulmonary vascular eng ##or ##ge ##ment . large hi ##atus hernia is stable .
pred: 3. correct value: 0
1 . no acute cardiopulmonary process . 2 . mild cardio ##me ##gal ##y is stable .
pred: 2. correct value: 1
in comparison to _ _ _ radiograph from earlier the same date , the left upper lobe is substantially better aer ##ated , but note is made of worsening ate ##lec ##ta ##sis in the left retro ##car ##di ##ac region with adjacent moderate pleural effusion . small to moderate right pleural effusion is apparently new and is accompanied by adjacent right lower lobe ate ##lec ##ta ##sis . exam is otherwise remarkable for placement of a new trache ##ostomy tube with tip termin ##ating 2 . 9 cm above the car ##ina .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality . bib ##asi ##la ##r scarring or subs ##eg ##mental ate ##lec ##ta ##sis .
pred: 3. correct value: 0
comparison to _ _ _ . no relevant change is noted . monitoring and support devices , including the ventricular assist device , are stable . minimal decrease in severity of the pre - existing mild pulmonary edema . no pneumothorax or other complications . stable appearance of the cardiac sil ##hou ##ette .
pred: 1. correct value: 3
persistent right apical pneumothorax . development of small left pleural effusion .
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ . technical limitations severely compromise the imaging quality . large area of opac ##ity projecting over the right mid ##lu ##ng could be fis ##su ##ral pleural fluid . moderate to severe cardio ##me ##gal ##y and dilatation of mediastinal and hil ##ar vessels have all progressed , exaggerated by supine positioning . no pneumothorax . et tube in standard placement .
pred: 3. correct value: 1
moderate to large right pleural effusion with right basilar opac ##ity likely reflective of ate ##lec ##ta ##sis . infection is not excluded .
pred: 1. correct value: 0
right subcl ##avi ##an pic ##c line and nas ##ogastric tube are unchanged in position . overall cardiac mediastinal contours are stable . no pneumothorax is seen . given differences in technique , the lungs remain grossly clear . no pulmonary edema . possible small layer ##ing left effusion .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute findings . possible mediastinal lymphadenopathy or mass . updated findings reported to dr . _ _ _ _ _ _ attending radiologist review by phone at 7 : 45 a . m . on _ _ _ .
pred: 1. correct value: 0
right mid lung consolidation has slightly decreased as compared to previous study . heart size and mediastin ##um are unchanged including cardio ##me ##gal ##y . no pneumothorax interval development of pleural effusion demonstrated .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
small left pneumothorax . volume loss at both bases .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
which result in bronch ##ovascular crowding , but beyond that there is likely moderate pulmonary edema presumably cardio ##genic in etiology . there may also be small bilateral pleural effusion ##s .
pred: 1. correct value: 0
of pneumonia .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette is more prominent and the pulmonary vessels are less well defined , consistent with increase in pulmonary venous pressure . no definite pleural effusion or acute focal pneumonia .
pred: 3. correct value: 1
no relevant change as compared to _ _ _ . normal size of the cardiac sil ##hou ##ette . no pulmonary edema . no pleural effusion ##s , no pneumonia . normal hil ##ar and mediastinal contours .
pred: 3. correct value: 2
clearing of pulmonary vascular congestion . subs ##eg ##mental ate ##lec ##ta ##sis .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the prominent opac ##ification in the left mid to upper zone is no longer present , suggesting that it represented an artifact or area of collapse relieved by expect ##oration of a mucous plug . mild haz ##y opac ##ification at the left base could reflect some layer ##ing pleural fluid with underlying ate ##lec ##ta ##tic changes . the right lung is essentially clear and there is no evidence of pulmonary vascular congestion .
pred: 3. correct value: 0
endotracheal tube has its tip 5 cm above the car ##ina . a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip not identified . a right pleural catheter remains in place . there is persistent retro ##car ##di ##ac consolidation likely reflecting lower lobe collapse with associated layer ##ing effusion . clinical correlation is advised as superimposed infection cannot be excluded . no pulmonary edema . small right apical pneumothorax . multiple right - sided rib fractures are again seen . air within the right lateral chest wall soft tissues consistent with subcutaneous emphysema . overall cardiac and mediastinal contours are stable . notification : the patient ' s nurse was notif ##ied of these findings by phone on _ _ _ at 12 : 30 at the time of discovery .
pred: 3. correct value: 0
et tube tip is 4 . 5 cm above the car ##inal . double tube tip is in the stomach . left subcl ##avi ##an line tip is at the level of mid sv ##c . bilateral pleural effusion ##s are extensive . pulmonary vascular congestion is noted , unchanged . no pneumothorax or new consolidation ##s demonstrated .
pred: 3. correct value: 0
compared to chest radiographs , _ _ _ through _ _ _ . mild pulmonary edema has worsened . bib ##asi ##la ##r consolidation could be dependent edema and ate ##lec ##ta ##sis but is concerning , particularly in the left lower lobe for pneumonia . on enlargement of cardio ##medi ##astin ##al sil ##hou ##ette is stable . pleural effusion ##s are presumed , but not large . no pneumothorax . endotracheal tube extends at least as far as less than 2 cm from the car ##ina , but the tip is obscure ##d by 2 esophageal tubes which pass into the stomach and out of view . left pic line can be traced as far as the upper right atrium but the tip is indis ##tin ##ct . right jugular line ends at the origin of the sv ##c .
pred: 3. correct value: 0
cardiac size cannot be evaluated . small bilateral effusion ##s with adjacent ate ##lec ##ta ##sis left greater than right are stable . there is no pneumothorax . left mid lung opac ##ity is unchanged . enteric tube tip is out of view below the diaphragm . left pic ##c tip is in the lower sv ##c . no other interval changes .
pred: 3. correct value: 1
right basal opac ##ity has progressed since the prior study , concerning for ate ##lec ##ta ##sis or potentially superimposed infection . left retro ##car ##di ##ac opac ##ity is unchanged . no pleural effusion is seen . alternatively giving the provided history of em ##esis , aspiration in the right lower lobe is another possibility and repeated radiograph in 12 hr might be considered
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitor and support devices are unchanged . again there is enlargement of the cardiac sil ##hou ##ette with diffuse bilateral pulmonary opac ##ification consistent with pulmonary edema . in the appropriate clinical setting , superimposed pneumonia or even ards would have to be considered .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is again enlargement of the cardiac sil ##hou ##ette with worsening pulmonary vascular congestion . opac ##ification at the bases probably reflects small pleural effusion ##s and compressive ate ##lec ##ta ##sis .
pred: 3. correct value: 1
newly placed ng tube terminate ##s in the stomach in good position .
pred: 3. correct value: 0
as compared to the previous image , no relevant change is seen . the lung volumes are normal . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures . no pneumonia , no pulmonary edema , no pleural effusion ##s . clips projecting over the right upper abdomen .
pred: 3. correct value: 2
but development of a smaller left - sided ling ##ula infiltrate during the same interval . considering patient ' s history of hiv , pcp infection is included in the diagnostic list .
pred: 3. correct value: 0
a diffuse coarse linear abnormality has developed in the lungs since _ _ _ . some of this is probably due to progression of extensive bilateral lower lobe pneumonia , seen to better advantage on chest ct performed _ _ _ elsewhere , but most of the change is probably asymmetrical ##ly distributed pulmonary edema . poor definition of the left main bronch ##us reflects extensive secretory retention , showed more clearly by the chest ct . the heart size is indeterminate due to new and extensive consolidation in the ling ##ula which obscure ##s the left heart border . small left pleural effusion is new or newly apparent . et tube is in standard placement and a left pic line ends in the left brach ##io ##cephal ##ic vein . there is no pneumothorax . findings were discussed by telephone with a member of the patient ' s care team at 9 a . m . on _ _ _ .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the monitoring and support devices are unchanged . the cardiac sil ##hou ##ette remains enlarged , though less prominent than on the previous study . there again is evidence of elevation of pulmonary venous pressure . the possibility of aspiration is difficult to exclude , especially in the retro ##car ##di ##ac region in the absence of a lateral view .
pred: 3. correct value: 1
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces . no evidence of pneumonia or cardiac decompens ##ation .
pred: 3. correct value: 0
1 . no pneumothorax . increase in mild to moderate right basilar ate ##lec ##ta ##sis with unchanged appearance of known left cav ##itary mass .
pred: 3. correct value: 0
in comparison to _ _ _ radiograph , pulmonary vascular congestion and mild edema are new . no other relevant change .
pred: 1. correct value: 0
limited study but no definite evidence of acute disease .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
comparison to _ _ _ . no change in appearance of the lung bases on the right , showing postoperative changes combines to a pneum ##oper ##itoneum , likely related to the placement of a feeding device in the stomach . stable position of the trache ##ostomy tube and the right pic ##c line . stable appearance of the left lung and the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
no definite evidence of pneumonia .
pred: 1. correct value: 0
new patchy opac ##ities in lung bases concerning for aspiration or pneumonia . extensive emphysema with scarring , architectural distortion , bronchi ##ect ##asis , and fibrosis in the right upper lobe with chronic right - sided volume loss .
pred: 1. correct value: 0
bib ##asi ##la ##r ate ##lec ##ta ##sis or scarring with chronic elevation of the right hemi ##di ##aph ##ragm . no acute cardiopulmonary abnormality otherwise noted .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no definite acute cardiopulmonary process . mild height loss of a mid thoracic vertebral body which is age indeterminate .
pred: 1. correct value: 0
multiple bilateral pulmonary nodules consistent with patient ' s known pulmonary amyloid disease as seen previously . there is no new opac ##ity suggestive of a focal infection .
pred: 3. correct value: 0
right - sided rib fractures better assessed on preceding ct . no radiographic evidence of pneumothorax although none definitively seen on the prior radiograph . right chest wall subcutaneous emphysema again seen . .
pred: 3. correct value: 0
left , dual lead pector ##al aic ##d with leads intact and in their expected positions . no evidence of pneumothorax .
pred: 3. correct value: 0
the course of the left pig ##tail pleural drainage catheter has changed since _ _ _ . the volume of the large multil ##oc ##ulated left pleural effusion is unchanged . left lower lobe is collapsed . moderate to severe ate ##lec ##ta ##sis in the right lower lobe has worsened . cardiac sil ##hou ##ette is largely obscure ##d . there is no pulmonary edema .
pred: 1. correct value: 3
underlying infectious process cannot be entirely excluded .
pred: 1. correct value: 0
the lung volumes are very low . there is mild to moderate pulmonary edema and areas of ate ##lec ##ta ##sis at the lung bases . mild cardio ##me ##gal ##y . no pleural effusion ##s . no pneumonia .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
intra - aortic balloon pump tip is 3 . 7 cm below the aortic groove . heart size and mediastin ##um are stable or minimally decreased . the patient continues to be in interstitial pulmonary edema but improved as compared to previous examination .
pred: 2. correct value: 1
pneum ##oper ##itoneum is demonstrated , might potentially be related to recent parac ##ente ##sis , slightly more conspicuous than on the prior study , attention on the subsequent studies is recommended . left basal consolidation and left pleural effusion are unchanged . there moderate in severity . there is no pulmonary edema . there is no pneumothorax . no focal consolidation ##s to suggest infection demonstrated .
pred: 3. correct value: 0
no radiographic evidence of intrath ##oracic metastasis or other significant cardiopulmonary abnormalities .
pred: 1. correct value: 0
ng tube with tip in the stomach .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
small bilateral pleural effusion ##s and mild interstitial pulmonary edema , progressed since _ _ _ exam .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of free intraperitoneal air .
pred: 1. correct value: 0
in comparison to the previous radiograph of 1 day earlier , bilateral pleural effusion ##s have apparently resolved , with associated improved aer ##ation at both lung bases . right lower lobe consolidation has slightly improved and is likely due to provided history of pneumonia . new bilateral upper lobe air ##space opac ##ities could reflect asymmetrical edema , aspiration , or extension of infectious pneumonia .
pred: 3. correct value: 0
low lung volumes and small bilateral pleural effusion ##s with overlying ate ##lec ##ta ##sis . central pulmonary vascular eng ##or ##ge ##ment .
pred: 1. correct value: 0
pulmonary edema accounting for the opac ##ities seen in the lungs bilaterally .
pred: 1. correct value: 0
interval increase in cal ##iber of the moderate to severely enlarged cardio ##medi ##astin ##al sil ##hou ##ette could be due to a combination of increasing mild to moderate cardio ##me ##gal ##y and progressive mediastinal fat deposition . the upper lungs are clear and there is no pleural effusion . on the lateral view heterogeneous opac ##ification projecting posterior to the heart could be a hi ##atus hernia . i can ' t exclude pneumonia , but it is unlikely . oblique views might be helpful in making the distinction .
pred: 3. correct value: 1
no change .
pred: 1. correct value: 0
heart size and mediastin ##um are unremarkable except for tort ##uous descending aorta . there is interval improvement of vascular enlargement and currently no overt pulmonary edema is seen . there is no pleural effusion or pneumothorax demonstrated .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . low lung volumes . mild pulmonary vascular congestion . 2 . probable bib ##asi ##la ##r ate ##lec ##ta ##sis . if there is continued concern for infection , a repeat exam with improved inspiratory effort to better assess the lung bases is recommended . 3 . renal oste ##odys ##tr ##oph ##y with severe compression deformity at the thorac ##ol ##umb ##ar junction with focal kyph ##osis .
pred: 1. correct value: 0
as compared to the previous radiograph , the right jugular vein catheter and the 2 right - sided chest tubes are in unchanged position . the lung volumes are constant but the extent of the pre - existing bilateral parenchymal opac ##ities , predom ##inating in the peri ##hi ##la ##r regions , have slightly increased . no new parenchymal opac ##ities . no visible pneumothorax . unchanged appearance of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , despite the a ple ##ur ##x 2 in place , there is substantial increase in the amount of right pleural effusion . remainder the study is unchanged .
pred: 1. correct value: 0
1 . over ##infl ##ated lungs and bronchial wall thickening , findings which could be due to chronic bronchitis in the setting of a history of smoking and chronic cough . 2 . no acute pulmonary abnormality .
pred: 3. correct value: 0
the patient has been ext ##ubated and the nas ##ogastric tube was removed . the left chest tube and the right internal jugular vein catheter are in unchanged position . the lung volumes have slightly increased , likely reflecting improved ventilation . unchanged mild cardio ##me ##gal ##y and unchanged extent of a pre - existing left pleural effusion . mild pulmonary edema is present on today ' s image .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
large right pleural effusion , moderate left pleural effusion , mild pulmonary edema , and left lower lobe collapse are unchanged since _ _ _ . no pneumothorax . heart size top - normal .
pred: 3. correct value: 1
a focal opac ##ity in the right mid ##lu ##ng is concerning for a new focus of pneumonia . left mid and lower lung opac ##ities have improved since _ _ _ .
pred: 3. correct value: 0
1 . no focal consolidation 2 . central pulmonary vascular congestion and mild pulmonary interstitial edema . 3 . trace bilateral pleural effusion ##s .
pred: 3. correct value: 0
lungs are fully expanded and clear . no pneumonia . heart size is top - normal . moderate volume of stomach travers ##es the diaphragmatic hi ##atus hernia . there is no pleural abnormality . thoracic aorta is tort ##uous but not clearly dilated . .
pred: 3. correct value: 1
the previously seen tiny right apical pneumothorax has resolved . cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there are no focal consolidation ##s , pleural effusion , or pulmonary edema . there is subcutaneous emphysema along the chest wall .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no pneumothorax . no evidence of fracture within the limits plain radiography .
pred: 1. correct value: 0
as compared to the previous radiograph , there is no relevant change in appearance of the extensive bilateral parenchymal opac ##ities , likely associated to small pleural effusion ##s , right more than left . unchanged appearance of the cardiac sil ##hou ##ette . the position of the left pic ##c line is constant .
pred: 3. correct value: 1
low lung volumes with bib ##asi ##la ##r opac ##ities which are most likely ate ##lec ##ta ##sis although infection is not entirely excluded .
pred: 1. correct value: 0
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
possible minimal improvement in right lower lobe ate ##lec ##ta ##sis . otherwise unchanged chest radiograph .
pred: 1. correct value: 0
unchanged over last 24 hours ; however , any concurrently associated infection cannot be ruled out and its interpretation should be done in conjunction with the clinical history .
pred: 3. correct value: 0
no free air under the diaphragm . clear hyper ##infl ##ated lungs .
pred: 1. correct value: 0
multifocal pneumonia , most severe in the left lower lobe .
pred: 1. correct value: 0
1 . left basilar opac ##ity may be due to ate ##lec ##ta ##sis , but superimposed infection is also possible given the patient ' s clinical history . 2 . no evidence of lung hyper ##infl ##ation . notification : the above findings were communicate ##d via telephone by dr . _ _ _ to dr . _ _ _ at 06 : 19 on _ _ _ , _ _ _ min after discovery .
pred: 3. correct value: 0
increased cal ##iber to the heart and mediastinal and hil ##ar and pulmonary vessels probably due in part to supine positioning , but there is mild pulmonary edema , and infra ##hi ##la ##r ate ##lec ##ta ##sis or consolidation has worsened . followup advised to exclude aspiration pneumonia . et tube , in standard placement , upper enteric feeding tube passes into the stomach and out of view . no pneumothorax or substantial pleural effusion .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
lungs are fully expanded and clear . lateral view shows a new mediastinal abnormality posterior to the heart , probably a hi ##atus hernia , above which the esophagus is mildly dist ##ended with air . there is no pleural effusion or evidence of central lymph node enlargement . the heart is normal size . if this explanation does not fit the clinical profile , ct scanning would be diagnostic .
pred: 3. correct value: 1
as compared to the previous radiograph , 2 0 new left - sided chest tubes have been inserted . there is no visible pneumothorax . air collection in the left lateral soft tissues . unchanged normal appearance of the heart . unchanged appearance of the right lung .
pred: 3. correct value: 2
top normal heart size with pacemaker in place .
pred: 1. correct value: 2
in comparison with the study _ _ _ , the hemodialysis catheter has been removed by the patient and there is no evidence of pneumothorax . mild ate ##lec ##ta ##tic changes are seen at the left base . no vascular congestion or acute focal pneumonia .
pred: 1. correct value: 0
left lower lobe consolidation concerning for pneumonia in setting of patient ' s clinical history . these findings were discussed with dr . _ _ _ by dr . _ _ _ _ _ _ telephone at 12 : 30 on _ _ _ at the time findings were discovered .
pred: 2. correct value: 0
pneumonia .
pred: 1. correct value: 0
1 . probable small left pleural effusion and ate ##lec ##ta ##sis . no evidence of pneumonia . 2 . mild cardio ##me ##gal ##y .
pred: 3. correct value: 1
no definite rib fractures or pneumothorax . if there is further concern for rib fracture dedicated rib series may be performed .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
small right pneumothorax has almost completely resolved . right basal pig ##tail catheter remains in place . opac ##ities in the right lower lobe have improved . small right effusion has increase . severe cardio ##me ##gal ##y is a stable . retro ##car ##di ##ac opac ##ities have markedly worsened consistent with large amount of ate ##lec ##ta ##sis . ng tube tip is out of view below the diaphragm . left pic ##c tip is in the right atrium as before mild vascular congestion is a stable . bilateral peri ##hi ##la ##r opac ##ities larger on the left side have increased
pred: 3. correct value: 1
extensive bilateral heterogeneous pulmonary abnormality including likely cavitation in the right lower and nodules on the left , improved on the left between _ _ _ and _ _ _ , but not subsequently . involvement of the right lung has remained less severely affected cava but stable . small pleural effusion ##s are presumed . heart is not enlarged .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
right - sided pneumothorax is slightly larger compared to _ _ _ . notification : results were communicate ##d to dr . _ _ _ by dr . _ _ _ _ _ _ telephone on _ _ _ at 5 : 00 ##pm .
pred: 1. correct value: 0
1 . previously seen near - complete opac ##ification of the left lung is improved following bronchoscopy with partial re ##ope ##ning of the left upper lobe , unchanged appearance of left lung multifocal opac ##ities from _ _ _ and unchanged moderate left pleural effusion . 2 . appropriate placement of all supportive devices .
pred: 3. correct value: 0
as compared to the previous radiograph , the patient has developed a mild right pleural effusion with subsequent ate ##lec ##ta ##sis at the right lower lobe . postoperative appearance of the right hil ##us is normal . there is a mill ##imetric right apical pneumothorax . no evidence of tension . normal appearance of the heart and of the left lung .
pred: 3. correct value: 2
right apical opac ##ification , which is been more fully evaluated on the recent cta neck . mild pulmonary edema . small bilateral pleural effusion ##s . mild cardio ##me ##gal ##y . prominent pulmonary arteries suggest pulmonary arterial hypertension .
pred: 3. correct value: 1
1 ) no significant change compared with _ _ _ . 2 ) pic ##c line and ng tube in satisfactory position . 3 ) ate ##lec ##ta ##sis at the left base , with minimal blunt ##ing of the cost ##oph ##ren ##ic angle and elevated left hemi ##di ##aph ##ragm . of note , however , this appearance has progressed compared with _ _ _ , raising the question of focus of aspiration or pneumon ##ic infiltrate .
pred: 3. correct value: 0
no radiographic change compared to _ _ _ and no new central pulmonary vascular congestion .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there again is enlargement of the cardiac sil ##hou ##ette with evidence of elevated pulmonary venous pressure is well as right pleural effusion with compressive basilar ate ##lec ##ta ##sis . the left lung is essentially clear . right ij catheter tip again is in the mid to lower portion of the sv ##c .
pred: 3. correct value: 1
no acute intrath ##oracic process . vp shunt tubing noted .
pred: 1. correct value: 0
since the prior radiograph of _ _ _ , pulmonary vascular congestion and interstitial edema have developed , accompanied by a new moderate sized right pleural effusion with adjacent right basilar ate ##lec ##ta ##sis or consolidation . no other relevant changes .
pred: 1. correct value: 0
definite superimposed acute cardiopulmonary process , noting that subtle change would be difficult to discern .
pred: 3. correct value: 0
radiographic examination .
pred: 1. correct value: 0
1 . there is worsening pulmonary edema with associated bilateral small - to - moderate pleural effusion ##s , left greater than right , and associated bib ##asi ##la ##r air ##space disease , most likely representing compressive ate ##lec ##ta ##sis , although pneumonia cannot be entirely excluded . the patient ' s mandible obscure ##s the right apex . heart remains enlarged . a left - sided dual - lead pace ##r remains in place . no pneumothorax .
pred: 3. correct value: 0
clear lungs .
pred: 1. correct value: 0
do ##bb ##ho ##ff tube passes below the diaphragm with its tip being in the stomach . the ng tube tip is most likely in the stomach as well . right internal jugular line tip is at the level of mid sv ##c . there is otherwise no substantial change in the a left basal consolidation , pulmonary edema and bilateral pleural effusion ##s .
pred: 1. correct value: 0
new right lower lung pneumonia . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 1 : 53 pm , 2 minutes after discovery of the findings .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is no change or evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
increased bilateral effusion ##s .
pred: 1. correct value: 0
as compared to the previous examination , the parenchymal opac ##ities have increased in extent and severity . these opac ##ities , located in the right lung , now occupy most of the right hemi thorax . the show more extensive air bronch ##ograms than on the previous image . the right internal jugular vein catheter has been removed in the interval . unchanged mild cardio ##me ##gal ##y . mild fluid overload but no overt pulmonary edema . no larger pleural effusion ##s .
pred: 3. correct value: 1
1 . no displaced rib fracture . 2 . indis ##tin ##ct air ##space opac ##ity in the right lung base may be related to ate ##lec ##ta ##sis from low lung volumes or early consolidation , depending upon the clinical setting .
pred: 3. correct value: 0
lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 2. correct value: 0
persistent moderate pulmonary edema although improved since prior exam with probable moderate bilateral effusion ##s .
pred: 3. correct value: 0
1 . patchy opac ##ities within the lung bases may reflect ate ##lec ##ta ##sis , but infection is not excluded in the correct clinical setting . 2 . trace left pleural effusion .
pred: 1. correct value: 0
1 . tip of the et tube termin ##ating 6 . 7 cm above the car ##ina just at the thoracic inlet . 2 . high position of the ia ##bp with tip at the aortic arch and should be pulled back by 2 - 3c ##m for more standard position . 3 . severe bilateral pulmonary edema and small bilateral pleural effusion ##s . notification : findings were discussed with cc ##u resident by dr . _ _ _ _ _ _ phone at 11a ##m on _ _ _ , 5 minutes following discovery .
pred: 1. correct value: 0
bib ##asi ##la ##r ate ##lec ##ta ##sis and pulmonary vascular congestion are mild and slightly improved since prior . other findings are similar to prior .
pred: 3. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there are bilateral pleural effusion ##s , right greater than left which are stable in size . bib ##asi ##la ##r ate ##lec ##ta ##sis is seen . there are no pneum ##otho ##ra ##ces . no pulmonary edema or focal consolidation is seen .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
low lung volumes and elevated left hemi ##di ##aph ##ragm . possible very small left pleural effusion versus soft tissue attenuation at the left base . no evidence of pneumonia .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
moderate right pleural effusion , decreased compared to prior chest radiograph . no pneumothorax visualized .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary abnormalities or large lymphadenopathy .
pred: 1. correct value: 0
no significant interval change since chest radiographs of _ _ _ .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the right pig ##tail catheter has been removed . the degree of effusion and basilar ate ##lec ##ta ##sis is less prominent , though some of this may merely reflect a more upright position of the patient . decreasing ate ##lec ##ta ##tic changes on the left . no vascular congestion or acute focal pneumonia .
pred: 3. correct value: 0
however , follow - up radiographs are recommended within eight weeks in order to ensure resolution .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
1 . no acute cardiopulmonary process . 2 . decreased size of left lower lobe pulmonary mass . 5 - mm round opac ##ity superior to the left hil ##us is likely a vessel on end , although a small pulmonary nodule cannot be completely excluded .
pred: 3. correct value: 0
endotracheal tube within 1 cm from the car ##ina . this was discussed with dr . _ _ _ by dr . _ _ _ . left basilar opac ##ity suspicious for infection noting component of effusion are ate ##lec ##ta ##sis are also possible . additional left mid lung and right basilar opac ##ities potentially ate ##lec ##ta ##sis or additional sites of infection .
pred: 3. correct value: 0
compared to prior chest radiographs , _ _ _ through _ _ _ at 10 : 26 . moderate bilateral pleural effusion ##s , left greater than right , probably improved . no pulmonary edema . bib ##asi ##la ##r consolidation , left - greater - than - right , has probably improved in the left lower lobe , which is more likely pneumonia than the right . heart size normal . no pneumothorax . left subcl ##avi ##an central venous line ends in the upper sv ##c , right jugular catheter in the mid sv ##c .
pred: 3. correct value: 2
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces . no pneumonia .
pred: 1. correct value: 0
cardiopulmonary support devices are in standard placement ##s . no pneumothorax .
pred: 1. correct value: 0
increased opac ##ity in the left mid lung appears more extensive than on the prior ct chest concerning for ongoing or progressive pneumonia .
pred: 2. correct value: 0
stable chest examination with no evidence of new consolidation to suggest a superimposed infectious process . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 3 : 48 pm , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
no acute displaced rib fractures identified . if there is ongoing concern for rib fractures , recommend dedicated rib radiographs with a bb marker placed over the area of pain . recommendation ( s ) : no acute displaced rib fractures identified . if there is ongoing concern for rib fractures , recommend dedicated rib radiographs with a bb marker placed over the area of pain .
pred: 1. correct value: 0
left lower hemi ##th ##orax not fully included on the image and the left diaphragm is not included . enteric tube courses below the level of the car ##ina and off the inferior aspect of the image ; given that the left diaphragm is not included on the image , cannot confirm that enteric tube courses into the expected location of the stomach . suggest report centered more inferior . elevated right hemi ##di ##aph ##ragm .
pred: 1. correct value: 0
elevation the right hemi ##di ##aph ##ragm and opac ##ity at the right base which most likely represents ate ##lec ##ta ##sis and less likely infection . these findings were communicate ##d to dr . _ _ _ at 11 : 28 am on _ _ _ at the time of discovery by dr . _ _ _ .
pred: 1. correct value: 0
unremarkable study .
pred: 1. correct value: 0
1 . no recurrence of the left pneumothorax . 2 . nas ##ogastric tube can be advanced 3 - 4 cm to place all side ##port ##s past the gastroesophageal junction . 3 . persistent but improving right lung consolidation . these findings were communicate ##d via telephone by _ _ _ , md , to _ _ _ , pa , at _ _ _ on _ _ _ .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
residual loc ##ulated component laterally and probable 3 cm intra ##fi ##ss ##ural collection . followup radiograph in _ _ _ weeks may be helpful to document resolution and to exclude a solid pleural lesion .
pred: 1. correct value: 0
small bilateral pleural effusion ##s , right greater than left . stre ##ak ##y bib ##asi ##la ##r air ##space opac ##ities likely reflective of ate ##lec ##ta ##sis though infection in the right lung base cannot be completely excluded .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is still diffuse bilateral pulmonary opac ##ification , though slightly decreased from the previous study . monitoring and support devices remain in place .
pred: 1. correct value: 0
marked improvement of pulmonary congestive pattern and parenchymal densities , most likely the result of successful treatment of chf .
pred: 1. correct value: 3
heterogeneous abnormality in the right lung which developed between _ _ _ and _ _ _ has worsened appreci ##ably , now affecting mid and upper zones as well as the lower . the left lung is grossly clear . there is no pleural effusion . the abnormality consists of linear opac ##ities and background of ground glass . in the right upper lobe , it highlights region of emphysema or bronchi ##ect ##asis . the left lower lobe is mildly abnormal , but has not changed for several years . the heart size is normal and there is no good evidence for central lymph node enlargement or pleural effusion . patient has had median stern ##otomy . there is no good evidence for heart failure . differential diagnosis includes atypical infection and pulmonary hemorrhage and pulmonary drug reaction , particularly if the patient is receiving ami ##oda ##ron ##e . there is no discern ##able lung nodule . it is possible with ct scanning may yield additional information in terms of reaching a diagnosis if one is not already known . dr . _ _ _ was page ##d .
pred: 3. correct value: 2
blunt ##ing of the right cost ##oph ##ren ##ic angle may be due to a small right pleural effusion .
pred: 1. correct value: 0
no definite evidence of pneumonia . if symptoms persist , recommend repeat chest x - ray for further evaluation .
pred: 2. correct value: 0
pneumonia . possible tiny right pleural effusion .
pred: 1. correct value: 0
1 ) lines and tubes as described . no radio ##pa ##que foreign body to suggest retained catheter fragment is detected . please see comment above . 2 ) patchy opac ##ity at both lung bases . in the appropriate clinical setting , the differential diagnosis could include infectious infiltrates , but there are also low lung volumes , that would account for ate ##lec ##ta ##sis .
pred: 1. correct value: 0
edema .
pred: 1. correct value: 0
compared to _ _ _ , tiny left apical pneumothorax appears stable . left - sided pig ##tail catheter is unchanged in position . numerous metastatic lesions are seen bilaterally
pred: 3. correct value: 0
comparison to _ _ _ . the left chest tube was removed . a minimal air collection in the basal parts of the pleural space persists . minimal re ##accum ##ulation of left pleural fluid which is , however , restricted to the cost ##oph ##ren ##ic sinus . the appearance of the known calcified lymph nodes at the left hil ##us are stable . no change in appearance of the normal right lung .
pred: 3. correct value: 0
in comparison with the study _ _ _ _ _ _ , the right pig ##tail catheter has been removed . no definite pneumothorax . the lungs are clear with no evidence of vascular congestion . specifically , the cost ##oph ##ren ##ic angles are sharp and there is no evidence of appreciable pleural fluid .
pred: 3. correct value: 0
patient ' s chin partially obscure ##s the lung apic ##es . right apical opac ##ity may relate to apical pleural thickening although underlying consolidation is not excluded . ap lord ##otic view would be helpful for further evaluation and is recommended .
pred: 3. correct value: 0
3 chest radiographs show advancement of the trans ##esophageal feeding tube , with the wire style ##t in place into the upper portion of a nond ##ist ##ended stomach . been no other change in the chest radiographs since _ _ _ : 41 .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
enteric tube is folded in the distal esophagus with tip projecting over the region of the aortic arch . repositioning is suggested .
pred: 3. correct value: 0
no significant interval change when compared to the prior study .
pred: 1. correct value: 0
persistent right ##ward tracheal deviation due to left lobe thyroid enlargement . otherwise , clear lungs .
pred: 1. correct value: 0
base ate ##lec ##ta ##sis which is less likely trace left pleural effusion .
pred: 1. correct value: 0
worsened chronic moderate cardio ##me ##gal ##y , pulmonary vascular congestion and mild pulmonary edema . no evidence of pneumothorax or focal consolidation .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
mid - to - low sv ##c .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
opac ##ities in the left base are likely ate ##lec ##ta ##sis . if clinically indicated repeat radiographs with better inspiration is recommended .
pred: 1. correct value: 0
1 . significant interval improvement of the large right pleural effusion compared to the ct from _ _ _ . no evidence of a pneumothorax . 2 . persistent elevation of the right hemi ##di ##aph ##ragm may be secondary to subp ##ul ##mon ##ic fluid , phr ##enic nerve palsy , radiation fibrosis and / or volume loss .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
new right tunnel ##ed subcl ##avi ##an central line with distal tip projecting over mid sv ##c , however with significant kink in the course of catheter . otherwise no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . the radiograph shows new bilateral parenchymal opac ##ities at both the left and the right lung bases . in the appropriate clinical setting , the changes are highly suggestive of pneumonia . the presence of a minimal accompanying left pleural effusion cannot be excluded . the size of the cardiac sil ##hou ##ette continues to be at the upper range of normal . the right pector ##al port - a - cath is in stable correct position .
pred: 3. correct value: 1
edema and small left effusion .
pred: 1. correct value: 0
with airway inflammation and mucus impact ##ion on prior studies , without definite evidence for acute superimposed disease .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the the right ij catheter again extends to the mid to lower sv ##c . little change in the diffuse bilateral pulmonary opac ##ifications consistent with bilateral layer ##ing pleural effusion ##s and pulmonary vascular congestion . cardiac sil ##hou ##ette appears stable .
pred: 3. correct value: 1
compared to chest radiographs _ _ _ , most recently _ _ _ through _ _ _ . moderate right and small left pleural effusion ##s unchanged . upper lungs grossly clear . left lower lobe ate ##lec ##ta ##sis is likely . mild to moderate cardio ##me ##gal ##y unchanged .
pred: 3. correct value: 1
lung base for which non urgent chest ct is suggested . the last sentence of the impression was communicate ##d to the patient ' s pcp by the _ _ _ qa nurse via _ _ _ mail on _ _ _ after request by the resident .
pred: 1. correct value: 0
right internal jugular central line with its tip in the mid sv ##c , unchanged . small bilateral layer ##ing pleural effusion ##s with associated patchy opac ##ities likely reflect patchy ate ##lec ##ta ##sis . no evidence of pulmonary edema or pneumothorax . status post median stern ##otomy for cabg with stable postoperative cardiac and mediastinal contours .
pred: 3. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are clear . no pleural effusion or pneumothorax is present .
pred: 3. correct value: 2
in comparison with the study of _ _ _ , the left chest tube remains in place and there is no evidence of pneumothorax . the subcutaneous gas along the left lateral chest wall and lower left neck has slightly decreased . little overall change in the appearance of the heart and lungs . the pneum ##omed ##ias ##tin ##um is less prominent and there is again evidence of a lumbar fusion procedure .
pred: 3. correct value: 1
1 . no focal consolidation detected . 2 . bib ##asi ##la ##r right greater than left linear opac ##ities , likely scarring or ate ##lec ##ta ##sis . comparison to outside films , if they may be obtained , is advised .
pred: 3. correct value: 0
right , likely metastatic disease , better assessed on previous cts , difficult to assess whether any these opac ##ities represent lung infection on chest x - ray alone .
pred: 1. correct value: 0
1 . interval re - accumulation of a small - to - moderate sized right pleural effusion . there is persistent nodular ##ity at the right apex which would be concerning for pleural metastasis . the left lung remains grossly clear and without a pleural effusion . overall , cardiac and mediastinal contours are likely stable although the right heart border is obscure ##d by the pleural effusion and probable air ##space opac ##ity likely related to compressive ate ##lec ##ta ##sis of the right lower lobe . no evidence of pulmonary edema . no pneumothorax .
pred: 3. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
findings consistent with congestive heart failure without frank pulmonary edema .
pred: 1. correct value: 3
concern for nond ##is ##place ##d fractures of the lateral right eighth and possibly right nin ##th rib ##s . no pneumothorax or pleural effusion seen .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there again is enlargement of the cardiac sil ##hou ##ette with elevation of pulmonary venous pressure and tort ##uo ##si ##ty of the aorta . little change in opac ##ification at the right base and no evidence of pneumothorax . retro ##car ##di ##ac opac ##ification is again consistent with volume loss in the left lower lobe . the degree of pneumonia is difficult to assess , especially in the absence of a lateral view .
pred: 3. correct value: 1
large left effusion has increased . right lower lobe ate ##lec ##ta ##sis has improved . there is mild vascular congestion . cardio ##me ##gal ##y cannot be assessed . wide ##ning mediastin ##um and bilateral supra ##cl ##avi ##cu ##la ##r catheters are unchanged
pred: 3. correct value: 1
new since the prior study is increased opac ##ity in the right infra ##hi ##la ##r region , wor ##ris ##ome for pneumonia . small right pleural effusion .
pred: 1. correct value: 0
the trans ##esophageal drainage tube has been partially withdrawn , now ending at the gastroesophageal junction , and needs to be advanced 12 cm . increasing opac ##ification at the base the right lung is concerning for possible aspiration , transforming into pneumonia . heterogeneous consolidation of the left lung base is unchanged , for another likely focus of aspiration . small pleural effusion ##s are presumed . upper lungs are clear . heart size is normal . no pneumothorax . trans ##ven ##ous right atrial and right ventricular pace ##r leads follow their expected courses , unchanged .
pred: 3. correct value: 2
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
1 . right upper lobe pneumonia . 2 . right middle lobe opac ##ity might represent pneumonia versus ate ##lec ##ta ##sis . 3 . left - sided pleural effusion with concurrent ate ##lec ##ta ##sis and peripheral opac ##ity which might represent scarring although superimposed pneumonia cannot be excluded .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little change . cardiac sil ##hou ##ette remains within normal limits and there is no vascular congestion or acute focal pneumonia . persistent elevation of the right hemi ##di ##aph ##ragm ##atic contour . the tip of the long intestinal tube is not seen , though it extends at least to the lower body of the stomach .
pred: 3. correct value: 2
1 . low lung volumes . mild asymmetric opac ##ity at the right lung base is nonspecific , could represent developing infection in the appropriate clinical setting . 2 . mild pulmonary vascular congestion without frank pulmonary edema .
pred: 1. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is stable . left lower lobe retro ##car ##di ##ac ate ##lec ##ta ##sis is unchanged . there is no pneumothorax . there are no new lung abnormalities suggestive of aspiration pneumonia . there are no other interval changes
pred: 3. correct value: 0
1 . slight improvement in pulmonary edema with persistent right pleural effusion . 2 . no pneumonia .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette remains within normal limits and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
in comparison with the study of _ _ _ , the monitoring support devices are stable . continued enlargement of the cardiac sil ##hou ##ette with substantial pulmonary vascular congestion . opac ##ification at the right base with sil ##hou ##etting hemi ##di ##aph ##ragm is consistent with substantial layer ##ing effusion and volume loss in the right lower lung . less prominent effusion and ate ##lec ##ta ##tic changes seen on the left .
pred: 3. correct value: 1
no evidence of pneumonia .
pred: 1. correct value: 0
no previous images . low lung volumes with ate ##lec ##ta ##tic changes at the bases , especially on the right , following recent surgery . right chest tube is in place and there is no evidence of pneumothorax . no vascular congestion or acute focal pneumonia .
pred: 1. correct value: 0
a small amount of improved aer ##ation on the left with continued near complete opac ##ification of the left hemi thorax
pred: 2. correct value: 0
as compared to the previous image , there is mild improvement of the pre - existing right pleural effusion . the left pleural effusion is unchanged . mild fluid overload persists . normal size of the cardiac sil ##hou ##ette . unchanged appearance of the monitoring and support devices .
pred: 3. correct value: 2
1 . low lung volumes with clear lungs . no consolidation or pulmonary edema . 2 . unchanged position of endotracheal tube which terminate ##s in the mid ##tra ##che ##a approximately 3 . 7 cm above the car ##ina . lines and tubes as above .
pred: 2. correct value: 0
right mainst ##em bronch ##us intubation .
pred: 1. correct value: 0
no definite acute cardiopulmonary process . the emergency medicine team queried whether presence of ground glass opac ##ities . no definite ground - glass opac ##ity is seen , please note that chest ct is more sensitive in the detection of such .
pred: 1. correct value: 0
aspiration pneumonia .
pred: 1. correct value: 0
no definitive abnormalities to explain patient ' s symptoms demonstrated within the limitations of the study technique .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ and most recently _ _ _ . mild edema has developed in the right upper lobe . lungs are otherwise clear . heart size normal . there is no pneumonia . no pneumothorax or pleural effusion . small region of luc ##ency beneath the right hemi ##di ##aph ##ragm could be colonic inter ##position or of more concern , poorly pneum ##oper ##itoneum . clinical correlation advised . vascular stents extending to right brach ##io ##cephal ##ic vein and sv ##c are unchanged , with mild narrowing above the level of the first rib stable since at least _ _ _ . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 11 : 58 am , 1 minutes after discovery of the findings .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
dilatation or tort ##uous ##ity .
pred: 1. correct value: 0
1 . right internal jugular dual - lumen catheter is unchanged in position . the heart remains enlarged . mediastinal contours are stable . there is a persistent increasing patchy opac ##ity at the left lung base which either represents worsening ate ##lec ##ta ##sis or an evolving pneumonia . clinical correlation is advised . small layer ##ing left pleural effusion . no evidence of pulmonary edema or pneumothorax .
pred: 3. correct value: 1
previous large pneum ##oper ##itoneum no longer visible . new opac ##ification in the right upper lung with volume loss could be largely ate ##lec ##ta ##sis but raises concern for pneumonia . et tube is in standard position , with the chin flex ##ed . upper enteric drainage tube passes into a non - dist ##ended stomach . the gut in the upper abdomen remains moderately to severely dist ##ended . heart is moderately enlarged , unchanged , but there is no vascular congestion , edema or appreciable effusion .
pred: 3. correct value: 0
significant interval change observed during the latest 20 hours examination interval .
pred: 1. correct value: 0
right internal jugular venous catheter terminate ##s at the level of low sv ##c .
pred: 1. correct value: 0
lung volumes are appreci ##ably lower today , accounting for increased density at the lung bases due to ate ##lec ##ta ##sis . low lung volumes exagger ##ate heart size which is probably top - normal and pulmonary vascular cal ##iber , but there is no pulmonary edema . pleural effusion ##s are small if any .
pred: 3. correct value: 1
comparison to _ _ _ . the patient has taken a deep breath in and the lung volumes have increased . borderline size of the cardiac sil ##hou ##ette . stable mild elevation of the left hemi ##di ##aph ##ragm . mild elongation of the descending aorta persists . no pneumonia , no pulmonary edema , no pleural effusion ##s .
pred: 3. correct value: 1
likely left basilar opac ##ity seen on lateral view suspicious for left lower lobe aspiration or infection . notification : findings discussed with dr . _ _ _ by dr . _ _ _ on _ _ _ at 104 ##0 ##am , 1 hour after they were made .
pred: 3. correct value: 0
as compared to the previous radiograph , the bilateral chest tubes are in unchanged position . the right port - a - cath is also unchanged . the extensive bilateral parenchymal opac ##ities are constant in extent and severity . minimal pleural effusion ##s are constant and are limited to the area of the cost ##oph ##ren ##ic sinuses . no evidence of pneumothorax .
pred: 3. correct value: 0
no acute findings .
pred: 1. correct value: 0
effusion ##s unchanged from 3 days prior .
pred: 1. correct value: 0
mild pulmonary edema is improved . residual bib ##asi ##la ##r opac ##ities makes it difficult to rule out pneumonia in the lower lobes .
pred: 1. correct value: 0
no change as compared to the previous examination . no pneumonia , no pulmonary edema . no pleural effusion ##s . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures .
pred: 3. correct value: 2
heart size is normal . mediastin ##um is normal . left pic ##c line tip is at the level of mid sv ##c . lungs are essentially clear . no pleural effusion or pneumothorax is
pred: 3. correct value: 2
1 . no focal consolidation identified . 2 . diffuse parenchymal reticul ##ation suggestive of interstitial lung disease , unchanged and consistent with known sarcoidosis .
pred: 2. correct value: 0
previous mild pulmonary edema has resolved . heart is mildly enlarged . no pleural effusion .
pred: 2. correct value: 0
no significant interval change in mild pulmonary edema with small bilateral pleural effusion ##s .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
since _ _ _ , a new opac ##ity has developed in the left lower lobe , resulting in increased opac ##ity over the lower thoracic spine on the lateral view . in the appropriate clinical setting , this may reflect a developing infectious pneumonia . differential diagnosis includes focal aspiration and ate ##lec ##ta ##sis . cardio ##me ##gal ##y and tort ##uo ##si ##ty of the thoracic aorta are unchanged . .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are unchanged . the cardiac sil ##hou ##ette remains prominent and there again is evidence of bilateral layer ##ing pleural effusion ##s . however , the hemi ##di ##aph ##ragm on the right is more sharply seen , raising the possibility that this is a manifestation of a more erec ##t position of the patient . retro ##car ##di ##ac opac ##ification process , consistent with continued volume loss in the left lower lobe . no evidence of acute pneumothorax .
pred: 3. correct value: 1
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
small left pleural effusion . no focal consolidation .
pred: 1. correct value: 0
comparison to _ _ _ . the lung volumes remain low . in the interval , the patient has developed mild pulmonary edema as well as bilateral basal parenchymal opac ##ities with subtle air bronch ##ograms , likely reflecting either pneumonia or aspiration . moderate cardio ##me ##gal ##y with retro ##car ##di ##ac ate ##lec ##ta ##sis .
pred: 3. correct value: 1
lungs are well expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes are normal . small left pleural effusion or left posterior pleural scarring is unchanged .
pred: 3. correct value: 0
right lower lobe pneumonia . follow up radiographs after treatment are recommended to ensure resolution of this finding .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there again is a small left apical pneumothorax . the right ij catheter again extends to the right atrium . it could be pulled back approximately 3 cm to definitely be above the cav ##oa ##trial junction . continued enlargement of the cardiac sil ##hou ##ette with substantial clearing of the ate ##lec ##ta ##tic changes at the left base . the right lung remains essentially clear .
pred: 3. correct value: 1
as compared to the previous radiograph , there is no relevant change . low lung volumes . areas of ate ##lec ##ta ##sis at the left and right lung bases . no new focal parenchymal opac ##ities . no overt pulmonary edema . borderline size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
several small regions of ate ##lec ##ta ##sis or consolidation , particularly in the lower lungs are stable . mild cardio ##me ##gal ##y is unchanged . thoracic aorta is generally large and tort ##uous , not appreci ##ably changed since _ _ _ . there is no pulmonary edema . pleural effusion ##s are minimal .
pred: 3. correct value: 1
moderately severe pulmonary edema has changed in distribution , more on the left , less so on the right , but not in overall severity . moderate right pleural effusion is larger . moderate cardio ##me ##gal ##y and mediastinal vascular eng ##or ##ge ##ment are stable . aer ##ation of the left lower lobe has diminished , usually due to combination of ate ##lec ##ta ##sis and edema , but concerning for infection . a second region of possible focal consolidation is a nodular opac ##ity projecting over the anterior aspect of the right first rib which , alternatively , could be due to bony sclerosis . followup advised with conventional radiographs if feasible . there is no pneumothorax .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
lungs hyper ##infl ##ated . cardio ##me ##gal ##y is severe . heterogeneous ##ly distributed interstitial abnormality could be edema in the setting of emphysema . there are at least 2 small nodules in the right mid and upper lung , best evaluated with ct scanning . ct scanning would also be helpful to see if there is a focus of pneumonia in the left mid ##lu ##ng projecting superior to the cardiac apex . left - sided skin fold should not be mist ##aken pleural effusion or pneumothorax , and pleural effusion if any is minimal . left ##ward displacement of the trachea at the thoracic inlet is most often due to an enlarged right thyroid lobe .
pred: 3. correct value: 1
compared to prior chest radiographs _ _ _ and _ _ _ at 05 : 48 . right lower lobe is still collapsed . pulmonary vascular congestion has increased slightly . heart is moderately enlarged . bilateral pig ##tail pleural drainage catheter still in place . no pneumothorax or appreciable pleural effusion . esophageal drainage tube ends in the upper portion of a nond ##ist ##ended stomach .
pred: 1. correct value: 0
the results of the study were relay ##ed by dr . _ _ _ to dr . _ _ _ _ _ _ by phone at 9 : 31 a . m . on _ _ _ .
pred: 1. correct value: 0
large left pleural effusion is responsible for severe right ##ward mediastinal shift and collapse of much of the left lung . the fusion is new since _ _ _ , but was present earlier in the day one an abdomen ct showed it was layer ##ing posteriorly and nonh ##em ##orrh ##agic . it may however have increased over the past 10 hr .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . there is a 0 . 6 cm nodule in the left upper lobe , potentially a calcified granuloma but not fully characterized by conventional radiographs . recommend comparison to prior imaging to assess stability . if these are not available for comparison , recommend nonc ##ont ##ras ##t ct of the chest for further evaluation . 2 . bib ##asi ##la ##r ate ##lec ##ta ##sis . no evidence of pneumonia , as clinically questioned .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
cardio ##me ##gal ##y is stable . vascular congestion has almost completely resolved . bib ##asi ##la ##r opac ##ities have markedly improved . there are no new lung abnormalities or evident pneumothorax . there is a large hi ##atal hernia . if any there is small right pleural effusion . degenerative changes in the thoracic spine are noted . wedge - shaped compression fracture in lower thoracic vertebral body and lumbar hardware are partially imaged
pred: 3. correct value: 1
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
in comparison with recent studies , there is increased opac ##ification at the right base with a configuration wor ##ris ##ome for substantial volume loss in the right middle and lower lobes in addition to pleural effusion . this could well be due to a mucous plug ##ging . the opac ##ification at the left base appears to be decreasing . the monitoring and support devices have all been removed . notification : dr . _ _ _ , _ _ _ for dr . _ _ _ .
pred: 1. correct value: 0
small bilateral pleural effusion ##s with subj ##acent ate ##lec ##ta ##sis / consolidation . unchanged mid to lower lung zone opac ##ities . small right basilar pneumothorax .
pred: 1. correct value: 0
tiny bilateral pleural effusion ##s . no focal consolidation .
pred: 1. correct value: 0
1 . moderate - to - severe cardio ##me ##gal ##y , with more prominent right atrial dilation , accompanied by pulmonary vascular eng ##or ##ge ##ment is concerning for congestive heart failure . 2 . possible right upper lobe pneumonia . evaluation with pa and lateral radiographs is recommended for more optimal evaluation .
pred: 3. correct value: 1
hyper ##infl ##ated lungs suggesting emphysema . no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process , including no focal consolidation to suggest pneumonia . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ _ _ _ , the referring provider request ##ing _ _ _ wet read , on the telephone on _ _ _ at _ _ _ : 45 am , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
no acute cardiopulmonary process . if the patient compl ##ains of focal chest tenderness , dedicated rib films could be performed . notification : these findings were discussed with dr . _ _ _ by dr . _ _ _ _ _ _ telephone at 9 : 46 ##am on _ _ _ , 2 hours after discovery .
pred: 3. correct value: 0
there is cardio ##me ##gal ##y which is stable . there has been development of a left - sided pleural effusion and left retro ##car ##di ##ac opac ##ity which has increased in size since prior . there is ate ##lec ##ta ##sis versus developing infiltrate at the right base . no pneum ##otho ##ra ##ces or overt pulmonary edema is seen .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the _ _ _ support devices as essentially unchanged . haz ##y opac ##ification at the bases with poor definition of the hemi ##di ##aph ##ragm ##s is again consistent with layer ##ing pleural effusion ##s and basilar ate ##lec ##ta ##sis . again there is mild elevation of pulmonary venous pressure .
pred: 3. correct value: 0
the opac ##ity in question appears to represent degenerative change at a cost ##over ##tebral joint .
pred: 1. correct value: 0
support lines and tubes are unchanged in position . cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there is a persistent left retro ##car ##di ##ac opac ##ity . there is minimal pulmonary vascular congestion . persistent right basilar opac ##ity is seen . there are no pneum ##otho ##ra ##ces . overall findings are stable .
pred: 3. correct value: 0
overall stable examination from 4 hours prior .
pred: 1. correct value: 0
posteriorly on the lateral view . underlying basilar infection not entirely excluded .
pred: 1. correct value: 0
1 . resolution of previously pleural effusion ##s . 2 . stable postoperative appearance .
pred: 3. correct value: 0
new nodular opac ##ities within both upper lobes , left greater than right . findings are compatible with metastases , as was noted in the lung bases on the subsequent ct of the abdomen and pelvis performed later the same day .
pred: 1. correct value: 0
mild pulmonary edema and small right pleural effusion .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no evidence of pneumonia . notification : the above findings were communicate ##d via telephone by dr . _ _ _ to _ _ _ taking calls for dr . _ _ _ at 14 : 45 on _ _ _ , _ _ _ min after discovery .
pred: 1. correct value: 0
re ##accum ##ulation of fluid in left hemi ##th ##orax after chest tube removal . notification : the findings were discussed by dr . _ _ _ with _ _ _ , np on the telephone on _ _ _ at 3 : 42 pm , 2 minutes after the images were reviewed .
pred: 1. correct value: 0
occasions .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . there is gas beneath the right hemi ##di ##aph ##ragm , consistent with pneum ##oper ##itoneum related to recent surgery .
pred: 3. correct value: 0
the right internal jugular catheter now terminate ##s in the mid to distal sv ##c .
pred: 1. correct value: 0
1 . diffuse pulmonary edema . 2 . possible pneumonia in the left lower lung .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
no change .
pred: 1. correct value: 0
no acute abnormalities suggestive of pneumonia identified .
pred: 1. correct value: 0
low lung volumes with crowding of the bronch ##ovascular structures and mild bib ##asi ##la ##r ate ##lec ##ta ##sis , similar compared to the prior exam . no acute osseous abnormalities are detected . if there is continued concern for rib fracture , a dedicated rib series is recommended .
pred: 3. correct value: 0
ling ##ular opac ##ity demonstrated on the prior study is not as well seen on the current study and may have been due to ate ##lec ##ta ##sis . no definite focal consolidation is seen
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there again are low lung volumes that accent ##uate the transverse diameter of the heart . little if any elevation of pulmonary venous pressure . left basilar opac ##ification suggests volume loss in the lower lobe with pleural fluid , which could be related to spl ##inting following rib fractures . no evidence of pneumothorax . left subcl ##avi ##an catheter again extends to the lower sv ##c .
pred: 3. correct value: 1
no radiographic evidence for acute cardiopulmonary process .
pred: 1. correct value: 0
patchy ate ##lec ##ta ##sis in the lung bases without focal consolidation . no pulmonary edema . moderate size hi ##atal hernia .
pred: 3. correct value: 0
interval improvement of the widespread air ##space opac ##ities .
pred: 1. correct value: 0
no pneumonia
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
patient is rotated to the left distor ##ting the architecture of the lungs . there is the suggestion of infra ##hi ##la ##r and left upper lobe consolidation , as well as the possible left hil ##ar adeno ##path ##y and obstruction or impact ##ion of the left lower lobe bronch ##us . heart is moderately enlarged and there is extensive calcification of the mitral annulus . when feasible , properly positioned conventional radiograph should be performed to see if ct scanning is indicated . there is no appreciable pleural effusion .
pred: 3. correct value: 0
heart size and mediastin ##um are stable . new right middle lobe opac ##ity wor ##ris ##ome for pneumonia . mild bib ##asi ##la ##r ate ##lec ##ta ##sis and small right pleural effusion . there is no pneumothorax . old calcified granulomas are present as well as rib fractures .
pred: 2. correct value: 3
1 . findings compatible with acute pulmonary edema with associated worsening pleural effusion ##s in the setting of cardio ##me ##gal ##y . 2 . right ##ward deviation of the trachea appears slightly more conspicuous than on prior but is felt to be due to patient ' s positioning . as before , evaluation with ultrasound is recommended . this may represent an enlarged thyroid but other mediastinal masses cannot be excluded .
pred: 3. correct value: 1
right mid lung ate ##lec ##ta ##sis has improved but has new linear ate ##lec ##ta ##sis in the right lower lung . mild pulmonary edema seen in retrosp ##ect has improved . significant decrease in mediastinal wide ##ning primarily due to less venous eng ##or ##ge ##ment
pred: 3. correct value: 0
lead , possibly not fixed in position .
pred: 1. correct value: 0
large right pleural effusion has continued to increase progressively since _ _ _ and _ _ _ . extensive central adeno ##path ##y in multiple pulmonary metastases not appreci ##ably changed . no pneumothorax . no pulmonary edema .
pred: 1. correct value: 0
moderate left pleural effusion is smaller . patient has severe emphysema , so the bilateral basilar consolidation , right greater than left could be dependent edema , since the heart is larger today than in _ _ _ left peri ##hi ##la ##r component has improved substantially . nevertheless pneumonia must be kept in mind .
pred: 3. correct value: 1
1 . acute exacerbation of recurrent chf . possible right lower lobe pneumonia in the .
pred: 1. correct value: 3
as compared to _ _ _ , the patient has been ext ##ubated . wide ##ning of vascular pedicle is present as well as slight increase in cardiac sil ##hou ##ette size there is no evidence of overt pulmonary edema , and there are no new areas of consolidation to suggest the presence of pneumonia .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the monitoring and support devices are essentially unchanged . there is again promin ##ence of the cardio mediastinal sil ##hou ##ette , though the degree of vascular congestion appears to have decreased . stre ##aks of ate ##lec ##ta ##sis are seen at the left base .
pred: 3. correct value: 0
as compared to the previous radiograph , the lung volumes have decreased and areas of ate ##lec ##ta ##sis have appeared at both the left and the right lung base . however there is no evidence of a circums ##cribed parenchymal opac ##ities suggesting pneumonia . borderline size of the cardiac sil ##hou ##ette without pulmonary edema . no larger pleural effusion ##s . no pneumothorax .
pred: 3. correct value: 1
no acute radiographic intrath ##oracic pulmonary disease .
pred: 1. correct value: 0
pulmonary edema possibly with superimposed pneumonia . small pleural effusion on the right , appears mildly increased . followup to resolution .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
low lung volumes with patchy bib ##asi ##la ##r opac ##ities likely reflecting ate ##lec ##ta ##sis . trace right pleural effusion versus pleural thickening . no evidence of pulmonary edema .
pred: 3. correct value: 0
findings consistent with pulmonary edema .
pred: 1. correct value: 0
comparison to _ _ _ . the course of the feeding tube is unremarkable , the tip projects in pre - pylori ##c position . no complications , notably no pneumothorax .
pred: 1. correct value: 0
new mild to moderate pulmonary edema .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
represents ate ##lec ##ta ##sis although an early consolidation cannot be excluded in the appropriate clinical setting .
pred: 1. correct value: 0
right lower lobe pneumonia . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 11 : 20 am .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is increasing promin ##ence of the cardiac sil ##hou ##ette with indis ##tin ##ct ##ness of pulmonary vessels , consistent with increasing pulmonary vascular congestion . areas of more coales ##cent opac ##ification are present at the bases , especially on the right . although this could merely represent ate ##lec ##ta ##sis and small effusion ##s , in the appropriate clinical setting it would be difficult to unequiv ##ocally exclude superimposed pneumonia in the retro ##car ##di ##ac region , especially on the right .
pred: 3. correct value: 1
the do ##bh ##off tube terminate ##s in the distal stomach .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the small apical pneumothorax on the right is not definitely appreciated . remainder of the study is unchanged , though there are slightly lower lung volumes . the dilatation of the gas - filled stomach is not appreciated at this time .
pred: 3. correct value: 0
congestion but not definite edema .
pred: 1. correct value: 0
1 ) small right effusion , with underlying collapse and / or consolidation , probably slightly worse compared with one day earlier . 2 ) previously described right apical pneumothorax is not appreciated on the current examination .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the endotracheal and nas ##ogastric tubes have been removed . little change in the appearance of the left jugular sheath . low lung volumes accent ##uate the transverse diameter of the heart . no definite pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 1
with persistent left lower lobe ate ##lec ##ta ##sis .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease or old tuberc ##ulous disease . blunt ##ing of the cost ##oph ##ren ##ic angle is again seen on the frontal view , though not on the lateral , suggesting some pleural thickening .
pred: 3. correct value: 0
1 . copd . 2 . increased right lung base opac ##ity concerning for pneumonia which could be due to infection and / or aspiration , with possible trace right pleural effusion . recommend followup to resolution in this patient with emphysema .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there has been placement of an endotracheal tube with its tip approximately 4 . 5 cm above the car ##ina . right ij sw ##an - gan ##z catheter tip is in the pulmonary outflow tract . nas ##ogastric tube extends at least to the upper stomach where it crosses the lower margin of the image . haz ##y opac ##ification of the right hemi ##th ##orax is consistent with layer ##ing effusion . minimal bib ##asi ##la ##r ate ##lec ##ta ##tic changes .
pred: 3. correct value: 0
no radiographic evidence for pneumonia . mild pulmonary vascular congestion .
pred: 1. correct value: 0
no pulmonary edema . possible trace pleural effusion ##s . top - normal to mildly enlarged cardiac sil ##hou ##ette .
pred: 3. correct value: 1
compared to chest radiographs _ _ _ . low lung volumes exagger ##ate mild increase in pulmonary vascular plethora . there is no pulmonary edema as yet . heart size is normal and mediastinal veins are not dist ##ended . et tube in standard placement . trans ##esophageal drainage tube passes into the stomach and out of view . no pneumothorax or appreciable pleural effusion . marked elevation of the right hemi ##di ##aph ##ragm is chronic .
pred: 3. correct value: 2
right subcl ##avi ##an pic ##c line , vp shunt , endotracheal tube , and feeding tube are unchanged in position . the heart remains markedly enlarged which may reflect cardio ##me ##gal ##y , although pericardial effusion should also be considered . lung volumes are low with layer ##ing bilateral effusion ##s and patchy bib ##asi ##la ##r opac ##ities suggestive of ate ##lec ##ta ##sis , although pneumonia cannot be entirely excluded . no obvious pneumothorax . an ivc filter is incompletely visualized .
pred: 3. correct value: 1
aspiration versus ate ##lec ##ta ##sis .
pred: 1. correct value: 0
lines and tubes are unchanged . no pneum ##otho ##ra ##ces are seen . there is unchanged air ##space opac ##ities bilaterally more confluent within the right base .
pred: 3. correct value: 0
persistent small left pleural effusion .
pred: 1. correct value: 0
as compared to _ _ _ radiograph , pulmonary vascular congestion has improved . improving asymmetrical left peri ##hi ##la ##r and basilar opac ##ities may reflect improving asymmetrical edema with or without coexisting infection . right pleural effusion has apparently resolved , and a small to moderate left pleural effusion has not appreci ##ably changed .
pred: 3. correct value: 0
1 . _ _ _ mm nodular opac ##ity projecting over the right upper lung appears new from _ _ _ and requires ct to further assess . 2 . large hi ##atal hernia again seen . recommendation ( s ) : chest ct to further assess right upper lobe _ _ _ mm nodule . notification : findings were discussed with dr . _ _ _ _ _ _ at _ _ _ : _ _ _ on _ _ _ .
pred: 1. correct value: 0
comparison to _ _ _ . the previous left large basolateral consolidation has decreased in extent and severity and has been partially replaced by a relatively widespread parenchymal opac ##ity . the left cost ##oph ##ren ##ic sinus , however , still remains blunted . the true extent of the process , in particular of the pleural component , is better appreciated on the lateral than on the frontal view . no new focal parenchymal opac ##ities . constant size of the cardiac sil ##hou ##ette . no pneumothorax .
pred: 3. correct value: 1
1 . slightly retr ##acted left pic ##c line termin ##ating at the superior cav ##oa ##trial junction . 2 . no evidence of pneumonia . 3 . chronic interstitial changes are unchanged .
pred: 3. correct value: 0
as compared to the previous image , both lower lobes , right more than left , show new parenchymal opac ##ities suggesting the presence of multifocal pneumonia . a plate ##li ##ke ate ##lec ##ta ##sis adjacent to the left hil ##us is constant . unchanged moderate cardio ##me ##gal ##y . unchanged mild fluid overload . no larger pleural effusion ##s . at the time of dict ##ation and observation , 15 : 34 , on the _ _ _ , the referring physician _ _ _ . _ _ _ was page ##d for notification .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no focal consolidation or pneumothorax .
pred: 1. correct value: 0
left lower lobe collapse is stable . moderate to severe right lower lobe ate ##lec ##ta ##sis has worsened , accompanied by increasing small to moderate left pleural effusion . heart size normal . upper lungs clear . et tube in standard placement . esophageal drainage tube passes into the stomach and out of view . right pic line ends in the mid to low sv ##c . no pneumothorax .
pred: 3. correct value: 2
persistent nodular ##ity in the right upper lobe , but overall marked decrease in opac ##ification . findings suggest improvement in malignancy and associated ate ##lec ##ta ##sis ; acute process is doubt ##ful .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . a pre - existing opac ##ity at both the left and the right lung bases has completely resolved . no pleural effusion ##s . no pneumonia . normal size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta .
pred: 3. correct value: 2
severe pulmonary edema has improved . asymmetric distribution raises the possibility of concurrent pneumonia , but all the findings could be due to edema since there has been a relatively substantial improvement over just four hours . moderate right pleural effusion stable . mild cardio ##me ##gal ##y unchanged . no pneumothorax .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
comparison to _ _ _ . no relevant change . correct position of the monitoring and support devices . low lung volumes persist . plate ##li ##ke areas of ate ##lec ##ta ##sis at the left lung bases . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 3. correct value: 0
stable slightly prominent interstitial process more marked at the lung bases which when correlated with a chest ct of _ _ _ could reflect residual bronchiol ##itis or an atypical infectious process . clinical correlation is recommended .
pred: 3. correct value: 0
1 . mild interval increase in pulmonary vascular congestion and new small left pleural effusion . 2 . long standing l1 vertebral wedge compression .
pred: 3. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ : 58 . no appreciable change in previous mild wide ##ning of the cardiac sil ##hou ##ette , 00 : 50 . small left pleural effusion and moderate left lower lobe ate ##lec ##ta ##sis unchanged . small right pleural effusion increased . upper lungs clear . no pneumothorax . right pic line ends at the origin of the sv ##c .
pred: 3. correct value: 1
moderate to large right - sided pleural effusion has enlarged since _ _ _ .
pred: 3. correct value: 0
in comparison to study obtained 12 hours prior , there is significant interval progression of pulmonary edema , which is now severe .
pred: 3. correct value: 0
previous vascular congestion has improved and borderline edema resolved . moderate bib ##asi ##la ##r ate ##lec ##ta ##sis and small pleural effusion ##s are unchanged . cardio ##medi ##astin ##al sil ##hou ##ette has a normal postoperative appearance ; pneum ##omed ##ias ##tin ##um is resolving . et tube in standard placement . tube cal ##iber is less than _ _ _ % of the tracheal diameter . sw ##an - gan ##z catheter ends in the region of the pul ##mon ##ic valve . esophageal drainage tube passes into the stomach . no pneumothorax .
pred: 3. correct value: 0
the left retro ##car ##di ##ac and basal opac ##ity has improved . the left small pleural effusion has also decreased . remaining multifocal opac ##ities in the upper lobes a right middle lobe are stable .
pred: 1. correct value: 0
as compared to _ _ _ chest radiograph , cardio ##medi ##astin ##al contours are stable in appearance in this patient status post previous median stern ##otomy and coronary bypass surgery . bi ##apical pleural and parenchymal scarring is also similar as well as a focal scar in the ling ##ula . no acute cardiopulmonary radiographic abnormalities are identified . compression deformity in lower thoracic spine is also unchanged .
pred: 3. correct value: 0
1 . mild pulmonary vascular congestion and mild pulmonary edema . 2 . opac ##ity in the left mid lung could represent focal consolidation or fluid within the fis ##su ##re , clinical correlation for infectious process is recommended . follow - up radiographs to show resolution are suggested in _ _ _ weeks .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
unchanged correct position of the endotracheal tube and the nas ##ogastric tube . in the interval , the lung volumes have slightly decreased and the retro ##car ##di ##ac ate ##lec ##ta ##sis has newly developed . minimal blunt ##ing of the left cost ##oph ##ren ##ic sinus could suggest the presence of a small left pleural effusion . otherwise the lung parenchyma is unchanged . unchanged size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
in comparison with the study _ _ _ _ _ _ , the right chest tube remains in place and there has been essentially complete re - expansion of the right lung . the left lung remains clear . the soft tissues adjacent to the right hemi ##th ##orax have been excluded from the image , so that it is impossible to assess the degree of subcutaneous gas .
pred: 1. correct value: 0
et tube . upper enteric tube terminate ##s at the relative location of the ge junction and should be advanced by 10 cm .
pred: 2. correct value: 0
lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 2. correct value: 0
to the recent chest ct .
pred: 1. correct value: 0
heart size is top - normal . mediastin ##um is stable . there is no evidence of pulmonary edema but bronchial wall thickening is demonstrated , more pronounced than on the prior study potentially representing interstitial overload . vascular stent in the right extreme et is demonstrated . it appears to be extended and lines compared to previous examination . no pleural effusion or pneumothorax is seen .
pred: 3. correct value: 1
lungs are low in volume . aside from plate ##li ##ke ate ##lec ##ta ##sis at the right base lungs are clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal . small gas collection projecting to the left of the sub ##gl ##ott ##ic trachea in the neck is in a zen ##ker ' s esophageal divertic ##ulum .
pred: 1. correct value: 0
represent early pneumonia . emphysema noted .
pred: 1. correct value: 0
as compared to the previous radiograph , a plate ##li ##ke ate ##lec ##ta ##sis at the right lung bases has developed . on the left , a mild pleural effusion is seen in almost unchanged manner . moderate cardio ##me ##gal ##y . no pulmonary edema . no pleural effusion ##s .
pred: 3. correct value: 1
compared to prior chest radiographs _ _ _ through _ _ _ at 11 : 40 . moderate pulmonary edema has worsened . severe cardio ##me ##gal ##y is larger . mediastinal veins remain severely dilated . pleural effusion ##s are presumed , at least moderate . no pneumothorax . et tube in standard placement . right jugular line ends in the low right atrium . esophageal drainage tube passes into the stomach and out
pred: 3. correct value: 1
1 . mild congestive heart failure without overt pulmonary edema . 2 . left basilar opac ##ity is likely ate ##lec ##ta ##sis and scarring , less likely infection .
pred: 1. correct value: 3
normal chest view .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
tip of the endotracheal tube is situated 9 mm above the car ##ina .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute process
pred: 1. correct value: 0
normal .
pred: 1. correct value: 0
1 . do ##bh ##off feeding tube terminate ##s in the stomach . 2 . no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
as compared to the previous radiograph , the lateral radiograph shows a new area of parenchymal opac ##ity , likely located in the right lower lobe and suspicious for pneumonia . mild fluid overload may be present . no overt pulmonary edema . borderline size of the cardiac sil ##hou ##ette . known right - sided metastatic rib lesion .
pred: 3. correct value: 1
no acute focal consolidation .
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ , 08 : 22 . mild pulmonary edema has worsened since earlier in the day . small right pneumothorax slightly smaller , and small right pleural effusion unchanged , , basal pig ##tail drainage catheter unchanged in position . heart size normal .
pred: 3. correct value: 2
no acute intrath ##oracic process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process . stable chest x - ray .
pred: 1. correct value: 0
minimal pulmonary vascular congestion . no focal consolidation to suggest pneumonia .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiographs .
pred: 1. correct value: 0
patchy bib ##asi ##la ##r air ##space opac ##ities likely reflect ate ##lec ##ta ##sis in the setting of low lung volumes , but infection is not completely excluded . consider repeat radiographs with improved inspiratory effort for further assessment .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
grossly no pneumothorax .
pred: 1. correct value: 0
stable small right apical pneumothorax .
pred: 1. correct value: 0
allowing for differences in technique and projection , there has not been a relevant change in the appearance the chest since recent study of _ _ _ . specifically , there are no new areas of consolidation to suggest development of a pneumonia .
pred: 3. correct value: 0
comparison to _ _ _ . no relevant change is noted . the patient carries a left pector ##al single lead pacemaker . moderate cardio ##me ##gal ##y and elongation of the descending aorta persist . no pulmonary edema , no pneumonia , no pleural effusion ##s .
pred: 3. correct value: 1
as compared to the previous radiograph , the pre - existing parenchymal opac ##ities have minimally decreased in extent . however , there is new blunt ##ing of the cost ##oph ##ren ##ic sinus on the right , a suggesting the presence of a small right pleural effusion . the monitoring and support devices , including the ecmo device , are in unchanged position . no pneumothorax .
pred: 3. correct value: 0
effusion .
pred: 1. correct value: 0
there is mild vascular congestion . faint peri ##bronchial opac ##ities could represent atypical infection . recommendation ( s ) : please correlate with clinical symptoms and close followup is recommend
pred: 1. correct value: 0
mild pulmonary vascular congestion and mild bib ##asi ##la ##r ate ##lec ##ta ##sis with possible trace bilateral pleural effusion ##s .
pred: 3. correct value: 0
from _ _ _ .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
slight blunt ##ing of the posterior left cost ##oph ##ren ##ic angle which may be due to a trace pleural effusion versus pleural thickening . basilar ate ##lec ##ta ##sis with possible involvement of the right middle lobe .
pred: 1. correct value: 0
diffuse and somewhat heterogeneous infiltr ##ative pulmonary abnormality developed between _ _ _ and _ _ _ and worsened dramatically over the next _ _ _ hours . since _ _ _ , it has worsened , and only minimally improved since _ _ _ . the heterogeneity of the abnormality suggests diffuse infection and / or pulmonary hemorrhage . moderate cardio ##me ##gal ##y is long ##standing , and preceded the development of pulmonary abnormality , so i doubt that it is simply cardio ##genic edema . nonc ##ardi ##ogenic edema ( ards ) is another possibility . ct scanning would be useful to look for cavitation , which would confirm infection . with the chin elevated , tip of the endotracheal tube at the thoracic inlet , 4 . 5 cm above the car ##ina is 2 cm above optimal placement . right internal jugular sheath ends in the upper sv ##c and right pic line in the lower . the upper enteric drainage tube passes into the stomach and out of view . small pleural effusion ##s are presumed . no pneumothorax .
pred: 3. correct value: 1
lung volumes have improved since _ _ _ and previous bands of subs ##eg ##mental ate ##lec ##ta ##sis have nearly resolved . lungs are otherwise clear . diameter of the cardiac sil ##hou ##ette has returned to normal . there is no pleural effusion or distension of either central mediastinal veins or pulmonary vessels .
pred: 3. correct value: 1
1 . expected position of support devices . 2 . little change in left lower lobe and retro ##car ##di ##ac air ##space opac ##ity and small pleural effusion ##s .
pred: 3. correct value: 0
moderate - to - large bilateral pleural effusion ##s and severe , relatively asymmetric pulmonary consolidation , probably due to pulmonary edema , unchanged over the past 48 hours . heart size , however , is normal . tip of the endotracheal tube is at the upper margin of the clav ##icles , no less than 4 . 5 cm from the car ##ina with the chin down . it should be advanced 2 cm for more secured seat ##ing . left pic line ends at the origin of the sv ##c and a right internal jugular line in the mid - to - low sv ##c . no pneumothorax . dr . _ _ _ was page ##d at 11 : 30 a . m .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
stable exam
pred: 1. correct value: 0
the left - sided pacemaker and stern ##otomy wires are unchanged . there is unchanged cardio ##me ##gal ##y . there has been worsening of the left retro ##car ##di ##ac opac ##ity . there is mild pulmonary interstitial edema . pleural calcifications are again seen . there are patchy opac ##ities throughout both lung fields which appear stable and correspond to the ground - glass opac ##ities seen on the prior ct scan , stable .
pred: 3. correct value: 1
no relevant change as compared to the previous examination . monitoring and support devices are in unchanged position , with the exception of the pic ##c line that shows a tip coiled inward ##s and potentially positioned in the az ##yg ##os vein . no other relevant changes .
pred: 3. correct value: 0
no acute pulmonary process identified . stable elevation of the right hemi ##di ##aph ##ragm . stable ate ##lec ##ta ##sis / scarring at both bases .
pred: 1. correct value: 0
left upper lobe linear opac ##ities at site of prior treatment for lung carcinoma . recommendation ( s ) : if clinically indicated a ct thorax can be considered to assess the left upper lobe in order to better differentiate post treatment scar from residual cancer .
pred: 3. correct value: 0
in comparison with the earlier study of this day , there has been placement of a endotracheal tube , with its tip only 1 cm above the car ##ina . this information has been immediately convey ##ed to dr . _ _ _ . there is still substantial pulmonary edema , though less prominent than on the previous study .
pred: 3. correct value: 0
improvement of the extensive left lower lung opac ##ification .
pred: 2. correct value: 0
clear lungs .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 ) et tube at the level of the lower medial clav ##icles , slightly high . clinical correlation requested . 2 ) bib ##asi ##la ##r opac ##ities . 3 ) unusual opac ##ity overlying left medial scap ##ula , possibly artifact versus non ##agg ##ress ##ive luc ##ent lesion . consider further evaluation with dedicated shoulder radiographs .
pred: 3. correct value: 0
left lower lobe opac ##ity , which could be seen with ate ##lec ##ta ##sis , although an infectious process is not excluded and results should be correlated with clinical presentation . no evidence of congestive heart failure .
pred: 1. correct value: 0
multiple pulmonary nodules consistent with known lung cancer . no convincing signs of superimposed pneumonia .
pred: 1. correct value: 0
compared to prior chest radiographs _ _ _ through _ _ _ at 18 : 31 . left lung collapse progressed on _ _ _ and was complete on _ _ _ . minimal re - expansion late in the day has revert ##ed to complete collapse . earlier radiographs suggested a large central hematoma . volume of left pleural effusion is indeterminate . right lung and right hemi thorax are unremarkable .
pred: 3. correct value: 0
no focal consolidation . persistent promin ##ence of the hil ##a which may be due to pulmonary arterial enlargement , which could be confirmed with none ##mer ##gen ##t chest ct .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no change .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
interval increase in right loc ##ulated hydro ##pn ##eu ##mo ##th ##orax .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ . lungs lung volume but grossly clear . more extra pleural and mediastinal fat has been deposited , obsc ##uring more of the cardiac sil ##hou ##ette . there is no evidence of cardiac decompens ##ation or intrath ##oracic infection . no pleural effusion .
pred: 3. correct value: 1
1 . status post right chest tube removal with minimal residual but improved apical pneumothorax . 2 . persisting right lower lung opac ##ity .
pred: 1. correct value: 0
trache ##ostomy is in place . , 5 cm above the car ##inal . cardio ##medi ##astin ##al sil ##hou ##ette is stable . right basal ate ##lec ##ta ##sis is noted in there is interval improvement of pulmonary edema .
pred: 1. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces . no evidence of pneumonia .
pred: 1. correct value: 0
comparison to _ _ _ . the patient has received a left pector ##al pacemaker . the leads are in correct position in the right atrium and right ventricle respectively . no complications , notably no pneumothorax . no pulmonary edema . elongation of the descending aorta is unchanged .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process . no significant interval change .
pred: 1. correct value: 0
slight improvement of left basal opac ##ification compared with the prior examination . a feeding tube extends into the body of the stomach . the second enteric tube extends beyond the field of view of this radiograph .
pred: 3. correct value: 0
unchanged position of the right pector ##al port - a - cath . the lung volumes have increased , likely reflecting improved ventilation . no larger pleural effusion ##s . the pre - existing bilateral parenchymal abnormalities , diffuse ##ly distributed in the lung parenchyma , have decreased in extent and severity , but are still clearly visible . interstitial predominance of the changes makes mild to moderate interstitial lung edema more likely than an infectious origin .
pred: 3. correct value: 0
no acute pulmonary process is identified . focal densities along the left chest wall are most suggestive of old healed rib fractures . if there is no no history to account for this , then dedicated left rib radiographs would be recommended . the scap ##ulae are within normal limits on these chest radiographs . if there is specific concern for scap ##ular fracture , then dedicated scap ##ular radiographs would be recommended . slight superior end ##plate scal ##lo ##ping of 1 of the mid thoracic vertebral bodies , question t7 is noted , but does not appear acute . again , clinical correlation is requested . recommendation ( s ) : if there is no history of left - sided rib fractures , then dedicated left rib radiographs would be recommended . if clinical suspicion for scap ##ular fracture remains high , then dedicated scap ##ular radiographs would be recommended .
pred: 3. correct value: 0
stable small right and small to moderate left pleural effusion ##s . persistent left lower lobe collapse . infection at the left base is possible in the appropriate clinical context .
pred: 3. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
small - to - moderate bilateral pleural effusion ##s are unchanged following thorac ##ente ##sis . region of dense consolidation in the right mid lung is clearing , presumably post - reex ##pan ##si ##on edema . there is also better aer ##ation of the previously densely consolidated left lower lobe . whether there is a small region of pneumonia in the abnormal lower lungs is radiographic ##ally indeterminate , but if present it is not worsening nor is there any pneumonia in the upper lungs . moderate cardio ##me ##gal ##y appears improved , but just because of differences in from ap to pa projection . right pic line ends in the upper right atrium . no pneumothorax .
pred: 3. correct value: 1
1 . mild increase in vascular eng ##or ##ge ##ment . 2 . interval obsc ##uration of the left cost ##oph ##ren ##ic angle . - - question small pleural effusion or early left lower lobe collapse and / or consolidation . if clinically indicated , an ap chest x - ray with increased inspiration and increased penetration and / or a lateral view could help for further assessment .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
moderate cardio ##me ##gal ##y is stable . lungs are fully expanded and clear . pulmonary vasculature is unremarkable . there is no pleural effusion .
pred: 2. correct value: 1
large right pleural effusion has increased . mild vascular congestion has increased . new retro ##car ##di ##ac opac ##ity is a combination of small effusion and ate ##lec ##ta ##sis . cardio ##me ##gal ##y cannot be assessed . wide ##ning of the mediastin ##um is unchanged . there is no pneumothorax
pred: 3. correct value: 1
1 . right retro ##car ##di ##ac opac ##ity , representing either ate ##lec ##ta ##sis or pneumonia . short term followup cx ##r is recommended for evaluation of interval resolution . 2 . small bilateral pleural effusion ##s .
pred: 1. correct value: 0
as compared to the previous radiograph , the right pleural drain was removed . there is re ##accum ##ulation of pleural fluid at the right lateral lung bases , causing increased radio ##den ##si ##ty in this region . the size of the cardiac sil ##hou ##ette , the known extensive consolidation ##s on the right as well as the left hemi thorax are of unchanged appearance .
pred: 3. correct value: 1
clear , hyper ##infl ##ated lungs .
pred: 1. correct value: 0
little overall interval change .
pred: 1. correct value: 0
no change .
pred: 1. correct value: 0
volumes are quite low . heterogeneous opac ##ification involves both lower lungs . heart is normal size and mediastinal vasculature is not eng ##or ##ged . findings include nonc ##ardi ##ogenic as well as atypical cardio ##genic edema and severe aspiration or diffuse pulmonary hemorrhage . dr . _ _ _ was page ##d at the time of dict ##ation .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiograph . no evidence of pneumonia or overt traumatic bony abnormality . if there is high suspicion and focal ##ity to physical examination , a dedicated rib series may be more sensitive for the detection of subtle rib fracture . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 2 : 42 pm , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
in comparison with the earlier study of this date , the right ij catheter has been pulled back to about the cav ##oa ##trial junction . endotracheal tube tip lies approximately 3 cm above the car ##ina . nas ##ogastric tube is essentially unchanged , as is the right subcl ##avi ##an catheter . there is a small amount of increased opac ##ification at both bases , most likely representing ate ##lec ##ta ##sis . in the appropriate clinical setting , superimposed pneumonia could be considered . of incidental note is a spinal fusion device in the lumbar region and at least 1 level of kyph ##oplasty .
pred: 3. correct value: 0
1 ) resolution of previously seen pulmonary edema . 2 ) no evidence of infection . 3 ) bilateral pleural effusion with bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
1 . stable appearance of right apical myc ##etom ##a . 2 . unchanged chronic promin ##ence of interstitial marking ##s .
pred: 1. correct value: 0
sw ##an - gan ##z catheter ends in the mid portion of the descending right pulmonary artery . severe cardio ##me ##gal ##y is stable . there is no pulmonary edema , pulmonary or mediastinal vascular eng ##or ##ge ##ment or pleural effusion . right jugular line ends in the mid sv ##c . the right pic line is partially obscure ##d by the pace ##r defibrill ##ator lead , but yes ##ter ##day 1 it was visible to the tip it ended in the mid sv ##c as well . the tip of the pace ##r defibrill ##ator lead projects over the left lower the right ventricle . there is no pneumothorax or plate appreciable pleural effusion . notification : .
pred: 3. correct value: 1
1 . large left and moderate - to - large right , bilateral pleural effusion ##s with bib ##asi ##la ##r air ##space opac ##ities likely reflecting compressive ate ##lec ##ta ##sis . 2 . mild pulmonary edema . 3 . known free air within the abdomen is not clearly visualized on the current study . 4 . no displaced rib fractures are noted . the study , however , is limited for the detection of rib fractures , though no acute rib fractures in the lower thorax were demonstrated on the recent ct of the abdomen .
pred: 3. correct value: 0
probable copd with small bilateral pleural effusion ##s .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
moderate cardio ##me ##gal ##y and mild pulmonary edema , but no focal consolidation ##s to suggest pneumonia .
pred: 0. correct value: 1
et tube and upper enteric drainage tube are in standard placement ##s respectively . mild - to - moderate cardio ##me ##gal ##y has worsened and small right pleural effusion has increased . heterogeneous opac ##ification in the lung bases is readily attributed to combination of ate ##lec ##ta ##sis and early edema . mediastinal venous eng ##or ##ge ##ment indicates elevated central venous pressure or volume . no pneumothorax .
pred: 3. correct value: 1
1 . improved aer ##ation of bilateral lung fields with stable cardio ##medi ##astin ##al sil ##hou ##ette . no pneumothorax . 2 . two scler ##otic lesions identified in the proximal humerus , only partially viewed on recent prior chest radiographs . recommend dedicated shoulder view radiographs in 3 months to confirm suspicion of bony islands . these findings were communicate ##d to the ordering physician via _ _ _ at the time findings were discovered at 10 : 54 on _ _ _ by dr . _ _ _ .
pred: 3. correct value: 0
interval dramatic improvement in widespread pulmonary opac ##ification with minimal residual right lower lung opac ##ification consistent with improving pulmonary edema and pneumonia .
pred: 3. correct value: 0
allowing for differences in technique and projection , there has not been a substantial change in the appearance of the chest since recent study of 1 day earlier . nas ##ogastric tube remains coiled within a large hernia , with distal tip directed cephal ##ad towards the lower esophagus .
pred: 3. correct value: 0
probable bib ##asi ##la ##r ate ##lec ##ta ##sis noting that infection or aspiration are not excluded . no pulmonary edema .
pred: 3. correct value: 0
improvement of mild pulmonary edema .
pred: 1. correct value: 0
moderate right pleural effusion is larger today than before , obsc ##uring the right lower lung , making it difficult to exclude parenchymal abnormality there . pulmonary vascular eng ##or ##ge ##ment is not accompanied by appreciable pulmonary edema . there is no left pleural effusion . heart size is normal and mediastinal veins are not dilated . hemodialysis catheter tips are in the low sv ##c and upper right atrium .
pred: 3. correct value: 2
compared to _ _ _ , small right and moderate left pleural effusion ##s are improving revealing stable moderate size consolidation at the right lung base that could be ate ##lec ##ta ##sis or pneumonia and improved left lower lobe ate ##lec ##ta ##sis . previous mild pulmonary edema has improved , as has probable pneumonia in the axillary region of the left mid ##lu ##ng . heart is probably moderately enlarged so substantially obscure ##d by pleural effusion and ate ##lec ##ta ##sis . no pneumothorax . right subcl ##avi ##an line ends close to the superior cav ##oa ##trial junction .
pred: 3. correct value: 0
relatively low lung volumes . increased promin ##ence of the right lower parat ##ra ##che ##al and hil ##ar soft tissue could be due to lymphadenopathy versus prominent vasculature or mediastinal / hil ##ar fat . this can be further assessed on non ##urge ##nt chest ct .
pred: 3. correct value: 0
there is no pneumothorax or appreciable right pleural effusion , pleural tube has been partially withdrawn . right lower lobe ate ##lec ##ta ##sis has improved substantially . et tube in standard placement . nas ##ogastric tube passes below the diaphragm and out of view . left lung clear .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
with the chin elevated , tip of the endotracheal tube is less than 15 mm from the car ##ina . it should be withdrawn at least 5 cm . heart is mildly enlarged and pulmonary and mediastinal vessels are eng ##or ##ged suggesting volume overload , but there is no pulmonary edema or appreciable pleural effusion and no pneumothorax . nas ##ogastric tube passes into the upper stomach but the tip is not visible . no pneumothorax .
pred: 3. correct value: 0
no comparisons are available . the patient carries a left pector ##al port - a - cath , the tip of the leads project over the right atrium and right ventricle respectively . better seen on the lateral and on the frontal radiograph are bilateral pleural effusion ##s , right more than left . subsequent areas of ate ##lec ##ta ##sis are seen over both lung bases . no evidence of pneumonia . borderline size of the cardiac sil ##hou ##ette with moderate tort ##uo ##si ##ty of the thoracic aorta . no pneumothorax
pred: 3. correct value: 1
slight increase in left basilar retro ##car ##di ##ac air ##space opac ##ity , likely representing ate ##lec ##ta ##sis versus pneumonia .
pred: 3. correct value: 0
moderate pulmonary edema .
pred: 1. correct value: 0
1 . decreased size of small bilateral pleural effusion ##s with improved aer ##ation at both lung bases and persistent mild ate ##lec ##ta ##sis . 2 . large air - fluid level in the neo ##es ##ophag ##us .
pred: 1. correct value: 0
no evidence of infection .
pred: 1. correct value: 0
new poorly defined right juxt ##a - hil ##ar opac ##ity , possibly due to an early / focal pneumonia given clinical suspicion for pneumonia . however , recurrent malignancy is an additional consideration , particularly considering adjacent persistent enlargement and increased density of the right hil ##um . management recommendation for this finding is treatment for pneumonia with short - term followup radiographs . however , as there is reportedly also a potential clinical concern for aortic dissection , an immediate chest cta should be considered as a cx ##r is not sufficiently sensitive or specific for detecting or excluding this diagnosis .
pred: 3. correct value: 0
normal chest .
pred: 1. correct value: 0
no focal consolidation or pneumothorax . probable asthma .
pred: 1. correct value: 0
1 . no evidence of acute cardiopulmonary abnormality . 2 . prominent gaseous distension of large bowel is consistent with reported _ _ _ ' s syndrome .
pred: 3. correct value: 0
lung volumes have improved and eng ##or ##ge ##ment of the pulmonary and mediastinal vasculature has decreased and mild cardio ##me ##gal ##y has improved . mild edema persists only in the lower lobes medial ##ly . small left pleural effusion is stable . no pneumothorax . dual channel right internal jugular line ends at the origin of the sv ##c , et tube is in standard placement , feeding tube passes into the stomach and out of view , trans subcl ##avi ##an right atrial right ventricular pace ##r leads follow their expected courses from the right axillary generator .
pred: 3. correct value: 1
termin ##ating either within the left brach ##io ##cephal ##ic or the upper sv ##c . evaluation limited due to rotated position .
pred: 3. correct value: 0
ng tube is in place in the stomach .
pred: 1. correct value: 0
since the recent study of earlier today , a left internal jugular vascular catheter is been placed , with tip approaching of the lateral wall of the proximal superior vena cava . no pneumothorax . exam is otherwise remarkable for increasing patchy opac ##ity at the right base , which could be due to localized ate ##lec ##ta ##sis , aspiration or developing pneumonia .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there again are low lung volumes that accent ##uate the transverse diameter of the heart . 2 - channel pace ##r remains in good position . promin ##ence of interstitial marking ##s is again consistent with elevation of pulmonary venous pressure . blunt ##ing of the cost ##oph ##ren ##ic angle is again seen . .
pred: 3. correct value: 1
suboptimal study due to low lung volumes . mild bib ##asi ##la ##r ate ##lec ##ta ##sis with crowding of the bronch ##ovascular structures .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
status post median stern ##otomy with stable cardiac and mediastinal postoperative contours . persistent layer ##ing small effusion ##s , left greater than right . retro ##car ##di ##ac consolidation favoring lower lobe ate ##lec ##ta ##sis , although pneumonia or aspiration should also be considered . probable mild peri ##hi ##la ##r edema . no pneumothorax .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process . stable chest x - ray .
pred: 1. correct value: 0
of acute disease .
pred: 3. correct value: 0
a right pic ##c termin ##ating at the mid sv ##c and nas ##ogastric tube termin ##ating within the stomach are unchanged in position . there is slightly improved aer ##ation since the _ _ _ examination . mild pulmonary vascular congestion and edema have slightly improved . trace bilateral pleural effusion ##s are unchanged . there is no pneumothorax .
pred: 3. correct value: 0
no acute findings .
pred: 1. correct value: 0
representing ate ##lec ##ta ##sis , though pneumonia not entirely excluded .
pred: 1. correct value: 0
aspiration given history .
pred: 1. correct value: 0
bib ##asi ##la ##r ate ##lec ##ta ##sis ; otherwise unremarkable .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . consolidation at the lung bases could represent aspiration or pneumonia in the appropriate clinical setting . 2 . compression deformities of multiple mid thoracic vertebral bodies are unchanged from _ _ _ .
pred: 1. correct value: 0
available , pa and lateral on _ _ _ : patient has had median stern ##otomy and a probable partial rib resection , mid ##level right hemi ##th ##orax . left lung is clear and normal volume . volume is slightly diminished in the right hemi ##th ##orax , presumably result of surgery . a peanut - shaped opac ##ity oblique ##ly oriented crossing the right mid lung , approximately 7 cm long is most likely pleural reaction and bone regr ##ow ##th following rib resection . oblique views would be helpful to confirm that and prior chest radiographs which undoubtedly exist somewh ##ere should be obtained to see if there are new findings warrant ##ing more imaging with chest ct . patient has had cabg . heart size is normal . pulmonary vasculature is unremarkable and there is no pulmonary edema . there is either minimal right pleural scarring or small effusion .
pred: 3. correct value: 2
1 . copd . 2 . mild cardio ##me ##gal ##y . upper zone redistribution , without overt chf . 3 . patchy opac ##ity left lower lobe . the possibility of an infectious infiltrate cannot be excluded . small bilateral effusion ##s present . 4 . prominent bilateral hil ##a , grossly stable over multiple prior films and similar to _ _ _ . possibility of lymphadenopathy cannot be excluded . clinical correlation is requested . 5 . small rounded nodular opac ##ity right upper zone . although this could represent an artifact due to overlap of vascular and osseous shadow ##s or poss ##ib ##ily callus related _ _ _ rib fracture , the possibility of a pulmonary nodule is difficult to exclude on these images . further assessment with ct should be considered . findings in item 4 and 5 were submitted to the clinical results dash ##board and discussed with dr . _ _ _ at approximately 5 : 26 pm on the day of the exam .
pred: 3. correct value: 1
compared to chest radiographs since _ _ _ , most recently _ _ _ . lung volumes have improved substantially . postoperative cardio ##medi ##astin ##al sil ##hou ##ette is as wide as expected from the preoperative appearance , subsequent unchanged . no pneumothorax . small left pleural effusion is presumed . moderate bib ##asi ##la ##r ate ##lec ##ta ##sis has improved . pulmonary vasculature is eng ##or ##ged but there is no appreciable edema . sw ##an - gan ##z catheter ends in the right pulmonary artery .
pred: 3. correct value: 0
as compared to the previous radiograph , the lung volumes have decreased . there is a minimal increase in extent of the known bilateral pleural effusion ##s . moderate cardio ##me ##gal ##y and minimal fluid overload persists . the apical lateral parenchymal opac ##ities are unchanged in appearance .
pred: 3. correct value: 1
moderate pulmonary edema with mild cardio ##me ##gal ##y and possible trace pleural effusion ##s , progressed from _ _ _ exam .
pred: 3. correct value: 1
compared with the previous exam there is interval decrease in size and wall thickness of the 2 cav ##itary lesions in the right upper lobe . no new consolidation or cav ##itary lesion .
pred: 1. correct value: 0
interval removal of left chest tube without remnant pneumothorax .
pred: 1. correct value: 0
a new nas ##ogastric feeding tube with a wire style ##t in place ends in the upper part of a non - dist ##ended stomach . mild - to - moderate cardio ##me ##gal ##y is stable . left ##ward mediastinal shift suggests that heterogeneous opac ##ification at the base of the left lung has a component of ate ##lec ##ta ##sis , not surprising given recent tracheal extubation , but raises concern for aspiration . clinical assessment advised . no pneumothorax .
pred: 3. correct value: 1
small to moderate right pleural effusion with right basilar ate ##lec ##ta ##sis . pneumonia is difficult to exclude , however , within the right lung base .
pred: 1. correct value: 0
stable right pneumothorax with slight decrease in right pleural fluid .
pred: 1. correct value: 0
as compared to the previous radiograph , the pre - existing right pleural effusion has mildly increased . the pre - existing opac ##ity , rounded , in the right lung apex is no longer visible on today ' s image . moderate cardio ##me ##gal ##y persists . no pulmonary edema . unchanged position of the left pector ##al port - a - cath .
pred: 3. correct value: 1
limited , negative .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
et tube tip just below the upper margin of the clav ##icles , approximately 6 cm in the car ##ina could be advanced to cm for more secure seat ##ing . left jugular line ends in the mid sv ##c . heart size is normal . widespread infiltr ##ative pulmonary abnormality consists of nodular and interstitial components unchanged since _ _ _ , improved slightly since _ _ _ . heart size is normal . sequence of changes over the past 3 weeks suggests some component of pulmonary edema , but the nodular abnormality is presumably infection , alternatively vasculitis . today ' s study also suggests right hil ##ar adeno ##path ##y . chest ct scanning what undoubtedly add anatomic information , and i hope it would be useful diagnostic ##ally as well
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no focal consolidation ##s concerning for pneumonia identified .
pred: 1. correct value: 0
as compared to the previous radiograph , the right internal jugular vein catheter has been removed . the small right pneumothorax is no longer visible . neither the frontal nor the lateral radiograph show evidence of pleural effusion ##s . unchanged clips and stern ##al wires of the cabg . no pneumonia , no pulmonary edema . normal size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 2
1 . left lower lobe pneumonia . 2 . lower lung volumes .
pred: 1. correct value: 0
as compared to the previous radiograph , the endotracheal tube and the sw ##an - _ _ _ catheter remain in situ . unchanged moderate cardio ##me ##gal ##y with mild pulmonary edema . unchanged bilateral areas of basilar ate ##lec ##ta ##sis . in addition , the pre - existing right basal lateral parenchymal opac ##ity . unchanged position of the pacemaker wires .
pred: 3. correct value: 1
1 . status post removal of chest tubes . no obvious pneumothorax detected . tiny pneumothorax might not be apparent . 2 . otherwise , i doubt significant interval change .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process . if high concern for rib fracture , dedicated rib series could be obtained .
pred: 2. correct value: 0
increased chf
pred: 1. correct value: 3
lungs are well expanded and essentially clear . there may be a tiny left pleural effusion blunt ##ing the posterior sulcus . heart size top - normal , increased slightly since _ _ _ . normal pulmonary vasculature . displacement of the trachea to the left in the low neck and thoracic inlet is primarily due to scoliosis , although the right thyroid lobe is larger than the left , see the cervical spine ct _ _ _ .
pred: 3. correct value: 1
cardio ##medi ##astin ##al sil ##hou ##ette .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
ng tube in adequate position . no acute cardiopulmonary process .
pred: 3. correct value: 0
aspiration / pneumonia and / or focal vascular congestion .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
bib ##asi ##la ##r consolidation , moderate on the left , milder on the right , has increased bilaterally since _ _ _ . either or both could be pneumonia . pulmonary vasculature is less eng ##or ##ged . heart size is top normal size , and mediastinal veins are still dilated . upper enteric drainage tube ends in the stomach . no pneumothorax .
pred: 3. correct value: 2
1 . new right internal jugular catheter terminate ##s in the mid sv ##c . 2 . lung volumes are decreased and bib ##asi ##la ##r ate ##lec ##ta ##sis , right greater than left , is new
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
the top of catheter projects with its tip . over the gastroesophageal junction . it should be advanced by at least 5 cm .
pred: 1. correct value: 0
mild interval progression of the bilateral lower lung zone air ##space consolidation ( concerning for aspiration pneumonia ) .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no signs for acute cardiopulmonary process .
pred: 1. correct value: 0
esophageal stent is unchanged in position from just above the level of the car ##ina to the ge junction . right middle lobe is fully consolidated . moderate right pleural effusion partially obscure ##s densely consolidated right lower lobe . left lower lobe pneumonia is also quite severe and unchanged . et tube is in standard placement . left pic line ends close to the superior cav ##oa ##trial junction . no pneumothorax .
pred: 3. correct value: 0
ate ##lec ##ta ##sis . if clinical concern for rib fracture persists , suggest dedicated rib series .
pred: 1. correct value: 0
no acute cardiopulmonary process . no evidence of free air beneath the diaphragm ##s .
pred: 2. correct value: 0
low lung volumes . no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
right internal jugular line tip is at the level of mid to lower sv ##c . et tube tip is 6 . 5 cm above the car ##inal . mediastin ##um is stable . bilateral pleural effusion ##s are large associated with bib ##asal consolidation ##s . cardio ##medi ##astin ##al sil ##hou ##ette is unchanged , including enlargement of the cardiac sil ##hou ##ette . .
pred: 3. correct value: 1
1 . standard positioning of the endotracheal and oro ##ga ##st ##ric tubes . 2 . focal opac ##ity in the right lung base could reflect infection or aspiration .
pred: 3. correct value: 0
disease .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
1 . no evidence of pneumonia . 2 . ov ##oid density overlying the left cardiac border , seen only on the pa view , likely a nip ##ple shadow . repeat films with nip ##ple markers may be obtained for further characterization .
pred: 3. correct value: 0
no significant interval change . moderate central vascular congestion without overt pulmonary edema .
pred: 3. correct value: 0
new right upper lobe pneumonia . mild pulmonary vascular congestion .
pred: 1. correct value: 0
et tube is appropriately positioned . increased , moderate , bilateral pleural effusion ##s with associated ate ##lec ##ta ##sis . mid left lung ate ##lec ##ta ##sis or developing pneumonia .
pred: 1. correct value: 0
superimposed acute process . please refer to subsequent ct for further details .
pred: 1. correct value: 0
1 . slight interval withdrawal of endotracheal tube , which terminate ##s 7 . 5 cm from the car ##ina . 2 . slight interval increase in large layer ##ing left pleural effusion .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . moderately severe bib ##asi ##la ##r ate ##lec ##ta ##sis has improved but lung volumes are still quite low . small right pleural effusion stable . upper lungs clear . heart size normal .
pred: 3. correct value: 2
mild interstitial pulmonary edema .
pred: 1. correct value: 0
minimal residual left basilar opac ##ification , but substantially improved .
pred: 1. correct value: 0
moderate pleural effusion ##s are increased than before . both lower lobes are persistently collapsed .
pred: 3. correct value: 0
stable small right apical pneumothorax . increase in small right effusion and adjacent ate ##lec ##ta ##sis
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . haz ##y opac ##ity at the right base is unchanged and is likely ate ##lec ##ta ##sis . 2 . findings consistent with copd .
pred: 1. correct value: 0
in comparison with the study _ _ _ , there is an placement of a pace ##r device with leads extending to the right atrium and apex of the right ventricle . no evidence of pneumothorax . remainder the heart and lungs is essentially unchanged .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
single chest view examination .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been virtually complete clearing of the right upper and lower lobe pneumonia . there may be minimal residual or fibrotic healing in the right upper lobe . otherwise the examination is within normal limits .
pred: 3. correct value: 0
no pneumothorax
pred: 1. correct value: 0
no acute process .
pred: 1. correct value: 0
persistent mild vascular eng ##or ##ge ##ment and interstitial marking ##s stable from the prior exam . no focal consolidation or large pleural effusion .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
widespread severe pneumonia continues to clear , the only any mild to moderate component of interstitial abnormality remaining in the lower lungs . heart is normal size . pleural effusion ##s _ _ _ if any . right pic line ends close to the superior cav ##oa ##trial junction .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the endotracheal tube has been removed . central catheter extends to the lower sv ##c . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion or pleural effusion . hypere ##x ##pan ##si ##on of the lungs suggests underlying chronic pulmonary disease , though no definite acute focal pneumonia is appreciated
pred: 3. correct value: 2
1 . improved chf with resolution of interstitial edema . 2 . lower lobe opac ##ity posteriorly on lateral view , which could represent a focal basilar pneumonia , ate ##lec ##ta ##sis or aspiration . followup chest x - ray may be helpful in this regard if warranted clinically .
pred: 1. correct value: 3
chest radiograph _ _ _ . previous right ##ward shift of the upper mediastin ##um has improved . this probably was lob ##ar ate ##lec ##ta ##sis , although i am not sure whether it was right upper or middle lobe collapse . small localized pleural fluid collection remains but there is no appreciable pneumothorax , apical pleural tube unchanged in position . small region of opac ##ification in each lower lung is presumably ate ##lec ##ta ##sis , but should be followed to exclude the possibility of pneumonia developing following aspiration . left upper lung is clear . heart size is normal . no pneumothorax .
pred: 3. correct value: 2
new small right pleural effusion with adjacent ate ##lec ##ta ##sis , stable small left pleural effusion .
pred: 1. correct value: 0
1 . large left pleural effusion and right ##ward mediastinal shift is increased than 1 day ago . small right pleural effusion is less 2 . right pleural catheter appears to have been withdrawn by 3 cm but terminate ##s within the chest change . notification : ipr ##ession 1 was discussed with _ _ _ , n . p . by _ _ _ , m . d . on the telephone on _ _ _ at 9 : 52 am , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
in comparison with the earlier study , the moderate left apical pneumothorax extending along the outer aspect of the upper half of the lung is essentially unchanged . otherwise little change .
pred: 1. correct value: 0
known pulmonary nodules re - demonstrated . no signs of pneumonia .
pred: 2. correct value: 0
new bib ##asi ##la ##r opac ##ities in the setting of very shallow inspiration , favor ate ##lec ##ta ##sis ; consider pneumon ##itis in the appropriate clinical setting .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the wide ##ning of the superior mediastin ##um is less prominent . dense ate ##lec ##ta ##tic stre ##aks at the right base are again consistent with ate ##lec ##ta ##sis . opac ##ification at the left base with sil ##hou ##etting the hemi ##di ##aph ##ragm is consistent with volume loss in the low left lower lobe and small left pleural effusion . no evidence of appreciable pulmonary vascular congestion .
pred: 3. correct value: 0
compared to chest radiographs , since _ _ _ , most recently _ _ _ . moderately severe bib ##asi ##la ##r ate ##lec ##ta ##sis has progressed . small bilateral pleural effusion ##s are larger . no pneumothorax . no pulmonary edema . normal postoperative cardio ##medi ##astin ##al sil ##hou ##ette .
pred: 3. correct value: 0
the feeding tube is partially folded in the stomach and the tip ends in the prep ##yl ##oric region . slight increased the pleural effusion on the right lung .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
there is no pneumothorax . residual right pleural effusion probably loc ##ulated , and substantial ate ##lec ##ta ##sis in the right lower lung are unchanged since earlier in the day following removal of two right pleural drain ##s . smaller left pleural effusion and mild left basal ate ##lec ##ta ##sis are stable . heart size top normal . pulmonary vascular congestion and borderline , but without pulmonary edema .
pred: 3. correct value: 2
right apical pneumothorax and diffuse subcutaneous emphysema .
pred: 1. correct value: 0
bowel jugular sw ##an - gan ##z catheter continues to have its tip in the right lower lobe pulmonary artery in the mid lung and should be pulled back approximately 5 - 6 cm as previously recommended . the intra - aortic balloon pump has its tip 1 . 2 cm below the aortic kn ##ob . the endotracheal tube and left internal jugular central line are unchanged in position . the nas ##ogastric tube now courses below the diaphragm with both the tip and side port seen over the proximal stomach . there has been substantial interval improvement in the bilateral air ##space opac ##ities consistent with resolving but residual edema . the pleural effusion ##s also seen to have decreased in size . stable cardiac and mediastinal contours . old right - sided rib fractures again seen .
pred: 3. correct value: 0
ate ##lec ##ta ##sis , though infection is not completely excluded .
pred: 1. correct value: 0
results were discussed with dr . _ _ _ at 1 : 52 p . m . on _ _ _ at the time the finding was discovered via telephone by dr . _ _ _ .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been some decrease in the amount of left pleural fluid following thorac ##ente ##sis . no evidence of post procedure pneumothorax . some residual effusion and volume loss in left lower lobe . single lead pace ##r again extends to the apex of the right ventricle .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the right ij catheter is unchanged . the head of the patient somewhat obscure ##s the left upper lung . however , the cardiac sil ##hou ##ette is essentially within normal limits without vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
stable posts ##urgical and post radiation changes in the right hemi ##th ##orax . no radiographic evidence of pneumonia or other acute cardiopulmonary abnormalities .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
position of the current right ventricular trans ##ven ##ous subcl ##avi ##an line from the right pector ##al pacemaker via a subcl ##avi ##an approach , is standard , though more proximal than the previous lead which passed at least as far as the cardiac apex . there is no pneumothorax , pleural effusion or wide ##ning of the cardio ##medi ##astin ##al sil ##hou ##ette to suggest tamp ##ona ##de . lung volumes have improved . there is no pulmonary edema or particular vascular eng ##or ##ge ##ment currently .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
moderate bilateral predominantly peri ##hi ##la ##r opac ##ities are new since earlier same - day chest radiograph and concerning for pneumonia . notification : the findings were discussed by dr . _ _ _ _ _ _ with rn _ _ _ on the telephone ##on _ _ _ at 11 : 33 am , 5 minutes after discovery of the findings .
pred: 3. correct value: 0
mild to moderate pulmonary edema .
pred: 1. correct value: 0
bib ##asi ##la ##r ate ##lec ##ta ##sis , pneumonia and / or aspiration .
pred: 1. correct value: 0
recent prior study .
pred: 1. correct value: 0
marked worsening in fluid status with near complete opac ##ification of the left hemi thorax from effusion and pulmonary edema also seen on the right
pred: 1. correct value: 0
post - radi ##ato ##n treatment changes in the right upper lobe for small cell lung cancer . severe emphysema . no new areas of lung opac ##ification are present , and there is no evidence of congestive heart failure .
pred: 3. correct value: 0
1 . no evidence of acute cardiopulmonary process . 2 . nodular opac ##ity overlying the right lower lung and anterior right fifth rib . to determine whether this is a lung nodule or the right nip ##ple or sclerosis in the anterior right fifth rib , shallow oblique views with nip ##ple marker should be obtained . notification : dr . _ _ _ reported the findings to _ _ _ qa nurses by receipt ##ed email on _ _ _ at 8 : 47 am , 5 minutes after discovery of the findings .
pred: 3. correct value: 0
persistent bib ##asi ##la ##r ate ##lec ##ta ##sis with increasing heterogeneous opac ##ity of the right lower lobe cardio ##ph ##ren ##ic angle region . developing pneumonia in this location cannot be excluded .
pred: 1. correct value: 0
_ _ _ on with the study of _ _ _ , there has been placement of an endotracheal tube with its tip approximately 3 cm above the car ##ina . the left subcl ##avi ##an pic ##c line tip is at the level of the cav ##oa ##trial junction . again there are very low lung volumes with mild ate ##lec ##ta ##tic changes at the right base . no vascular congestion or acute focal pneumonia .
pred: 1. correct value: 0
given the difference in patient position , migration of the right jugular line that ends behind the head of the right clav ##icle is less than a centim ##eter . generalized increase in peri ##bronchial opac ##ification affects both lungs but is most pronounced on the left where there are new regions of involvement suggesting progressive pneumonia . heart is top normal size and az ##yg ##os venous dist ##ention suggests elevated central venous pressure or volume , but the asymmetry of the pulmonary findings suggests that they are not due to pulmonary edema . pleural effusion is minimal if any . no pneumothorax . dr . _ _ _ _ _ _ i discussed these findings by telephone at the time of dict ##ation .
pred: 3. correct value: 0
large hi ##atal hernia . mild left base ate ##lec ##ta ##sis without focal consolidation . no pulmonary edema .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are essentially unchanged . there is again some elevation in pulmonary venous pressure with enlargement of the cardiac sil ##hou ##ette . ate ##lec ##ta ##tic changes are seen at the left base with poor definition of the medial aspect of the hemi ##di ##aph ##ragm , consistent with volume loss in the left lower lobe .
pred: 3. correct value: 1
as compared to _ _ _ , no relevant change is seen . left pector ##al pacemaker . normal size of the heart . no pleural effusion ##s . no pneumonia , no pulmonary edema . normal hil ##ar and mediastinal contours .
pred: 3. correct value: 2
in comparison with study of _ _ _ , there may be mild improvement in the still substantial left apical pneumothorax . otherwise no change .
pred: 3. correct value: 0
mildly worsened left basilar opac ##ity , likely ate ##lec ##ta ##sis . small pleural effusion ##s .
pred: 3. correct value: 0
1 . no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the endotracheal tube is been removed . there has been placement of a do ##bh ##off tube , though the opaque tip is only in the mid ##es ##ophag ##us . subsequent study dictated previously shows the tip in a catheter , of bone not satisfactory , position . there appears to be some improvement in the bib ##asi ##la ##r opac ##ification .
pred: 3. correct value: 0
since a recent radiograph from several hr earlier , a right basilar pneumothorax is newly appreciated with ind ##welling chest tube . interval decrease in width of cardio ##medi ##astin ##al contours likely reflects provided history of evacuation of hematoma . note is also made of improving bib ##asi ##la ##r ate ##lec ##ta ##sis and decreasing pleural effusion ##s . sw ##an - gan ##z catheter has been withdrawn to the level of the main pulmonary artery . no other relevant changes since the recent study .
pred: 3. correct value: 0
1 . mild pulmonary edema and small bilateral pleural effusion ##s . 2 . patchy right infra ##hi ##la ##r opac ##ity . recommend repeat radiograph after di ##uresis to exclude infection or aspiration pneumonia .
pred: 3. correct value: 0
lung volumes are lower on the current study which serves to exagger ##ate pulmonary vascular cal ##iber and the abnormal background intersti ##tium of the lungs present on prior studies . heart size is top normal . mediastinal veins may be dilated . i would recommend repeat conventional radiographs as soon as feasible to see if the vascular abnormalities and interstitial edema are genuine , and to evaluate the left lung apex , which shows greater opac ##ity medial ##ly than the right . all of these findings could be artifacts of low lung volume .
pred: 3. correct value: 2
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , of the endotracheal tube has been pulled back , so that the tip lies approximately 6 cm above the car ##ina . the patient has taken a much better inspiration . nas ##ogastric tube coils in the fundus and then extends to at least the lower body of the stomach . there is poor definition of a small portion of the left hemi ##di ##aph ##ragm . this suggests small layer ##ing effusion with compressive ate ##lec ##ta ##sis at the base . no evidence of vascular congestion .
pred: 3. correct value: 0
volumes ; however , given history , infection is not completely excluded . clinical correlation suggested .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
as compared to the previous radiograph , the nas ##ogastric tube has been removed . also removed is the right internal jugular vein catheter . the right chest tube and a left pic ##c line persists . moderate cardio ##me ##gal ##y persists . normal postoperative appearance of the right hemi thorax , with a small pleural effusion and a basilar ate ##lec ##ta ##sis . the ate ##lec ##ta ##sis at the left lung bases is constant .
pred: 3. correct value: 1
moderate to severe tracheal narrowing due to enlarged thyroid . otherwise , normal chest radiograph
pred: 1. correct value: 0
no acute process .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . previous mild pulmonary edema has resolved and pulmonary vascular congestion has improved . cardio ##me ##gal ##y is mild to moderate , decreased since _ _ _ . moderate bib ##asi ##la ##r ate ##lec ##ta ##sis has increased . no pneumothorax . et and nas ##ogastric drainage tubes in standard placement ##s .
pred: 3. correct value: 1
vascular congestion .
pred: 1. correct value: 0
left pic ##c line tip is at the level of mid sv ##c . cardio ##medi ##astin ##al sil ##hou ##ette is unchanged . bilateral pleural effusion ##s are substantial . right chest tube is in unchanged location . there is interval development of pulmonary edema . loc ##ulated pleural effusion a adjacent to the right hil ##us is unchanged . overall findings are concerning for rapid progression of a currently moderate interstitial pulmonary edema .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
trace bilateral pleural effusion ##s . grossly stable enlargement of the cardiac sil ##hou ##ette given differences in inspiration . no overt pulmonary edema .
pred: 2. correct value: 1
as compared to the previous radiograph , the tip of the endotracheal tube is now approximately 1 . 7 cm above the car ##ina . the other monitoring and support devices are constant . the extensive bilateral parenchymal opac ##ities are unchanged in extent and severity .
pred: 2. correct value: 0
single frontal view shows lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 1. correct value: 0
normal heart lungs hil ##a mediastin ##um and pleural surfaces . no evidence of pneumonia .
pred: 3. correct value: 0
as compared to the previous radiograph , the patient carries a feeding tube . the tip of the tube is not visualized on the image . otherwise the radiograph is unremarkable . normal size of the cardiac sil ##hou ##ette . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 1. correct value: 2
no acute cardiopulmonary process . no definite evidence of free air . however , if persistent clinical concern , further evaluation with ct should be considered .
pred: 3. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices have been removed except for the right ij catheter . following chest tube removal , there is no evidence of pneumothorax . continued opac ##ification at the left base is consistent with volume loss in the left lower lobe and pleural fluid .
pred: 3. correct value: 0
as compared to _ _ _ , 03 : 58 , the pleural effusion on the right has decreased of the thorac ##ocent ##esis . a mini drain is visible in the right pleural space . there is no evidence of pneumothorax . minimal ate ##lec ##ta ##sis at the right lung bases persist . borderline size of the cardiac sil ##hou ##ette without pulmonary edema .
pred: 3. correct value: 1
comparison to _ _ _ . the external pacemaker was removed . newly placed left pector ##al pacemaker . the single lead projects over the right ventricle . no evidence of pneumothorax . mild elevation of the left hemi ##di ##aph ##ragm . no pulmonary edema . no pneumonia .
pred: 3. correct value: 0
1 . low lung volumes , though no definite consolidation . 2 . unchanged mediastinal wide ##ning may be due to a dilated aorta . cross - sectional imaging would be recommended for confirmation .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
support lines and tubes are unchanged in position . there has been marked worsening of the consolidation throughout both lung fields . this involves all lobes bilaterally . superimposed pulmonary edema is also possible . no pneum ##otho ##ra ##ces are seen .
pred: 3. correct value: 0
low lung volumes within new bib ##asi ##la ##r linear opac ##ities , likely ate ##lec ##ta ##sis . no lob ##ar consolidation present . the patient is rotated giving rise to apparent cardio ##me ##gal ##y with obsc ##uration of medial right lower zone .
pred: 3. correct value: 1
as compared to _ _ _ radiograph , lung volumes are lower , accent ##ua ##ting the cardiac sil ##hou ##ette and bronch ##ovascular structures . allowing for this difference , there has not been a substantial change in the appearance of the chest since recent study .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no pulmonary edema . possible trace right pleural effusion .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
1 . no focal consolidation or gross effusion . minimal bib ##asi ##la ##r ate ##lec ##ta ##sis may be present . 2 . upper zone redistribution . 3 . previously seen increased interstitial marking ##s are less apparent . i suspect this may be due to slight bl ##urring from motion .
pred: 1. correct value: 0
no significant interval change . no convincing evidence of pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
heterogeneous opac ##ification at the left base is stable after having improved substantially since 6 . on the right , however , there is more other similar abnormality . findings are suggestive of recurrent aspiration . upper lungs are clear . heart size is normal .
pred: 3. correct value: 2
subtle bib ##asi ##la ##r opac ##ities wor ##ris ##ome for multifocal infection . known bronchi ##ect ##asis was better seen on prior ct scan .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . no pneumonia . 2 . calcifications projecting over the central heart would be better evaluated with echocardiography . telephone notification to dr _ _ _ by dr _ _ _ at 9 : 00 on _ _ _ .
pred: 1. correct value: 0
edema has improved substantially on the right , along with decrease in previous moderate right pleural effusion , now small . however , there is worsening of peri ##hi ##la ##r consolidation in the left lung , presumably dependent edema . moderate - to - severe cardio ##me ##gal ##y is stable . there is at least some left pleural effusion , and no evidence of pneumothorax .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
the heart remains enlarged which may reflect cardio ##me ##gal ##y although a pericardial effusion cannot be excluded . left subcl ##avi ##an pic ##c line remains unchanged in position with its tip at the cav ##oa ##trial junction . bilateral parenchymal process with more consolid ##ative components in both lung bases likely reflects a combination of pulmonary edema , pneumonia and or pulmonary hemorrhage . overall , the edema may have slightly improved . clinical correlation is recommended . there is likely a layer ##ing left effusion . no large pneumothorax is seen , although the sensitivity to detect pneumothorax is diminished given supine technique .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 ) overall similar to the prior film , but the degree of aer ##ated lung on the left appears somewhat smaller due to what is likely pleural fluid tracking along the left lung apex . 2 ) the interstitial marking ##s on the right are overall similar , but may be slightly more pronounced than on the prior film . 3 ) no obvious pneumothorax is detected , though a subtle pneumothorax might not be apparent .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
moderate right pleural effusion and right basal ate ##lec ##ta ##sis , increased from the prior study .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . monitoring and support devices remain in place . continued enlargement of the cardiac sil ##hou ##ette with bilateral effusion ##s and substantial volume loss in the left lower lobe . suggestion of areas pneum ##omed ##ias ##tin ##um , presumably related to previous esophageal perforation .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison to _ _ _ chest radiograph , bib ##asi ##la ##r air ##space consolidation ##s are new and concerning for pulmonary infection in the setting of a history of neutrop ##enic fever . bib ##asi ##la ##r distribution suggests the possibility of an aspiration pneumonia , but the appear is not specific for this entity . moderate right and small to moderate left pleural effusion are new .
pred: 3. correct value: 0
persistent right fluid filled pleural space . no significant change from the examination 2 hr prior .
pred: 1. correct value: 0
the edema continues to clear in the left lung , but worsening consolidation in the right lung is an indication of focal abnormality such as pneumonia or pulmonary hemorrhage . mild cardio ##me ##gal ##y more pronounced today . small right pleural effusion is presumed . no pneumothorax . et tube and left internal jugular line are in standard placement ##s and an upper enteric feeding tube passes into the stomach and out of view .
pred: 3. correct value: 1
mild - to - moderate pulmonary edema has worsened slightly over an hour . small right pleural effusion is stable . the heart is normal size , and the mediastinal veins are not dilated . nas ##ogastric tube ends in the upper stomach . left pic line ends in the low sv ##c . no pneumothorax .
pred: 3. correct value: 2
the tip and side port of the feeding tube are below the ge junction . heart size is within normal limits . there is slight promin ##ence of the pulmonary interstitial marking ##s at the bases , unchanged . no overt pulmonary edema or focal consolidation is seen . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 2
since _ _ _ , right pleural effusion , left pleural effusion , and loc ##ulated effusion border ##ing the posterior ple ##ura have decreased in size . unchanged bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
top - normal cardiac sil ##hou ##ette size without pulmonary edema . no focal consolidation to suggest pneumonia .
pred: 0. correct value: 1
multiple nodules are partially obscure ##d by increased pulmonary edema and left pleural effusion . pneumonia cannot be excluded . these findings were communicate ##d via telephone by dr . _ _ _ to dr . _ _ _ at _ _ _ on _ _ _ .
pred: 1. correct value: 0
consolidation due to pneumonia is not excluded .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is substantial increase in the amount of right pleural effusion with underlying compressive ate ##lec ##ta ##sis . small left effusion with basilar ate ##lec ##ta ##sis . no evidence of pulmonary vascular congestion .
pred: 3. correct value: 0
1 . minimally increased right lower lobe opac ##ity , either representing aspiration or pneumonia . 2 . cardio ##me ##gal ##y with unchanged mild interstitial edema .
pred: 3. correct value: 1
bib ##asi ##la ##r ate ##lec ##ta ##sis and mild blunt ##ing of the left cost ##oph ##ren ##ic angle which could be secondary to a small pleural effusion . no new focal consolidation .
pred: 1. correct value: 0
in comparison with the earlier study of this date , the patient has been re intu ##ba ##ted with the tip of the endotracheal tube approximately 5 . 5 cm above the car ##ina . nas ##ogastric tube extends well into the distal stomach . increasing opac ##ification at the bases with poor definition of the hemi ##di ##aph ##ragm ##s is consistent with layer ##ing pleural effusion and underlying compressive ate ##lec ##ta ##sis . the in the appropriate clinical setting , it would be very difficult to exclude superimposed pneumonia .
pred: 3. correct value: 0
1 . right upper lobe pneumonia and bilateral pleural effusion ##s . 2 . technically limited study . elevated left hemi ##di ##aph ##ragm . consider obtaining true ap view or pa and lateral if possible .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . elevation of the left hemi ##di ##aph ##ragm . unchanged position of the left pic ##c line and the nas ##ogastric tube . unchanged mild fluid overload . mild retro ##car ##di ##ac ate ##lec ##ta ##sis . no evidence of pneumonia . no larger pleural effusion ##s .
pred: 3. correct value: 0
no acute cardiopulmonary process . interval fracture of the rod just inferior to the superior most pedicle screw on the left .
pred: 2. correct value: 0
comparison to _ _ _ . the pre - existing pneumonia has completely cleared . slight scarring and subsequent pleural thickening are seen at the level of the lower left lateral lung , at the site of the previous infection . small hi ##atal hernia . normal size of the cardiac sil ##hou ##ette . left subcl ##avi ##an stent . status post lumbar stabilization surgery .
pred: 3. correct value: 2
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the nas ##ogastric tube now all takes a wide loop ##ed within the fundus of the stomach with the tip apparently in the mid body of the stomach below the lower margin of the image . other monitoring and support devices are stable . continued bilateral layer ##ing pleural effusion ##s with compressive ate ##lec ##ta ##sis at the bases .
pred: 3. correct value: 0
1 . focal opac ##ity overlying periphery of right mid lung is likely related to a healing pathologic rib fracture , but additional shallow oblique radiographs may be considered to exclude a focal pneumonia simulating a rib lesion , if warranted clinically . 2 . extensive myeloma ##to ##us involvement of imaged skeletal structures , including a high - grade compression deformity at l1 .
pred: 3. correct value: 0
as above .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . no evidence of pneumonia or pulmonary edema . no pleural effusion ##s . normal size of the cardiac sil ##hou ##ette . unchanged normal position of the nas ##ogastric tube . the vertebral fixation devices are constant .
pred: 3. correct value: 2
as compared to the radiograph from a day earlier , right sided pic ##c line in the lower sv ##c .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the tip of the left subcl ##avi ##an pic ##c line now lies in the mid sv ##c . otherwise , little change and no evidence of acute cardiopulmonary disease .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
new foreign body in the distal esophagus , which likely represents the battery that the patient recently swallow ##ed . notification : findings telephone ##d to _ _ _ by dr . _ _ _ on _ _ _ at 1 : 46 ##pm , time of discovery .
pred: 1. correct value: 0
1 . increased bilateral hil ##ar promin ##ence , probably hil ##ar lymphadenopathy . 2 . new right infra ##hi ##la ##r opac ##ification that could reflect consolidation or possibly a new lung nodule . recommend repeat chest ct for further characterization . notification : the above findings were post due to the radiology critical findings dash ##board on _ _ _ at 14 : 25 .
pred: 3. correct value: 0
interval resolution of the previously seen right lower lobe consolidation .
pred: 1. correct value: 0
no evidence of free air or pneumothorax . no focal air ##space consolidation to suggest pneumonia . no pulmonary edema .
pred: 1. correct value: 0
clips in the aort ##opulmonary window as well as at the gastroesophageal junction and postoperative changes in the right apical and param ##edia ##st ##inal areas are constant . minimal scarring at the right lung bases . no evidence of acute lung disease such as pneumonia or pulmonary edema . borderline size of the cardiac sil ##hou ##ette . minimal elongation of the descending aorta .
pred: 3. correct value: 1
patchy left basilar opac ##ity , likely ate ##lec ##ta ##sis . pneumonia is not completely excluded in the correct clinical setting .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process . hyper ##infl ##ated lungs compatible with history of emphysema .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the pic ##c line again extends to the lower sv ##c . there are low lung volumes with elevation of the right hemi ##di ##aph ##ragm ##atic contour and mild ate ##lec ##ta ##tic changes at the bases . no evidence of acute focal pneumonia or vascular congestion .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there has been placement of a right ij dialysis catheter that extends into the right atrium . continued enlargement of the cardiac sil ##hou ##ette with continued moderate pulmonary edema . the hemi ##di ##aph ##ragm ##s are more sharply seen , consistent with decreasing pleural fluid and basilar ate ##lec ##ta ##sis .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process . chronic interstitial lung disease is similar to before .
pred: 2. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ through _ _ _ at 19 : 00 . severe cardio ##me ##gal ##y is chronic and obscure ##s most of the left lower lobe and some of the right . nevertheless there is probably substantial bib ##asi ##la ##r consolidation , probably due to aspiration , all worse today than on _ _ _ , accompanied by pleural effusion ##s small to moderate in size . upper lobes do not show pulmonary edema . lateral view would be helpful in determining with the relative contributions of presum ##e aspiration pneumonia and pleural effusion ##s . no pneumothorax . this examination neither suggests nor excludes the diagnosis of pulmonary embolism
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little overall change . again there are relatively low lung volumes that accent ##uate the transverse diameter of the heart . no definite vascular congestion , pleural effusion , or acute focal pneumonia . tort ##uo ##si ##ty of the aorta is again seen . partial event ##ra ##tion of the right hemi ##di ##aph ##ragm is less prominent on the current study .
pred: 3. correct value: 1
ling ##ular pneumonia or possibly ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
interval increase in size of cardiac sil ##hou ##ette .
pred: 2. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . no acute cardiopulmonary process . 2 . age indeterminate compression of a mid thoracic vertebrae , likely t ##9 .
pred: 1. correct value: 0
clinically concerned , repeat radiograph can be performed in a less lord ##otic position .
pred: 1. correct value: 0
for pneumonia ; small bilateral pleural effusion ##s .
pred: 1. correct value: 0
mild hyper ##infl ##ation is unchanged , indicating small airway obstruction . there is no focal abnormality to suggest pneumonia . heart size , given the large lung volumes , is top - normal but there is no pulmonary edema or pulmonary vascular congestion . moderately extensive asbestos related pleural plaque , some calcified , is unchanged since the previous study and although there is no pleural effusion , lung lesion , or other strong suggestion of intrath ##oracic malignancy , or indication of developing pulmonary fibrosis , these determinations are made more reliably with chest ct scanning
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
since _ _ _ , previous moderate right pleural effusion has improved . mild peri ##bronchial opac ##ification at the lung bases is probably ate ##lec ##ta ##sis . there is no pulmonary edema or good evidence for pneumonia . heart size is normal . et tube is in standard placement , right jugular line ends in the mid to low sv ##c and a nas ##ogastric tube passes into the stomach and out of view .
pred: 3. correct value: 2
1 . possible very small left pneumothorax . 2 . small residual left pleural effusion . 3 . likely left lower lobe rounded ate ##lec ##ta ##sis , alternatively pneumonia . these findings were discussed with dr . _ _ _ by dr . _ _ _ _ _ _ telephone at approximately 4 p . m . on the day of the study .
pred: 1. correct value: 0
objects .
pred: 1. correct value: 0
abnormality .
pred: 1. correct value: 0
pulmonary abnormalities .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
hyper ##infl ##ated lungs , without evidence of pneumothorax .
pred: 1. correct value: 0
radiographic evidence for acute change .
pred: 1. correct value: 2
interval removal of the left - sided chest tube without appreciable pneumothorax . notification : the findings were discussed with _ _ _ , surgery , by _ _ _ , m . d . on the telephone on _ _ _ at 2 : 05 pm , 2 minutes after discovery of the findings .
pred: 1. correct value: 0
no acute process
pred: 1. correct value: 0
large area of consolidation in the right lower lung accompanied by an indeterminate volume of right pleural effusion is unchanged . severe cardio ##me ##gal ##y is chronic , accompanied by mild pulmonary vascular congestion but no definite pulmonary edema . right jugular line ends at the origin of the sv ##c . trans ##ven ##ous right atrial and right ventricular pace ##r defibrill ##ator leads are unchanged in their respective positions . there is no pneumothorax .
pred: 3. correct value: 1
chronic fine reticular opac ##ities of the lateral lung bases ; otherwise clear lungs .
pred: 3. correct value: 0
1 . patchy bib ##asi ##la ##r opac ##ities , which could be due to clinically suspected aspiration , although the appearance overlaps with ate ##lec ##ta ##sis and infectious pneumonia . 2 . complete right middle lobe collapse . 3 . new , small bilateral pleural effusion ##s . recommendation ( s ) : short - term followup radiographs to assess for resolution of pulmonary findings . notification : updated findings were d / w dr . _ _ _ by dr . _ _ _ by phone at 8 : _ _ _ a on the day of the exam .
pred: 1. correct value: 0
limited examination due to patient rotation . mild vascular congestion . no definite focal consolidation .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has been ext ##ubated and the nas ##ogastric tube was removed . the ventr ##icul ##oper ##itoneal shunt shows an unchanged course . no pneumonia , no pulmonary edema . no pleural effusion ##s . metallic particles over the right chest are seen in unchanged manner .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
heterogeneous consolidation at the base of the left lung has decreased in apparent extent but is more confluent centrally . therefore this could be due to collapse of a lobe previously involved with pneumonia . greater opac ##ification in the right lower lobe is also due to pneumonia or ate ##lec ##ta ##sis on that side which has increased since _ _ _ . heart size is normal . upper lungs are clear . pleural effusion ##s are presumed , but not large . the et tube in standard placement . feeding tube ends at the pyl ##or ##us . esophageal probe in place the midw ##ay between the car ##ina and gastroesophageal junction . no pneumothorax .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary disease .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
there is no pulmonary edema . heart size is normal but has increased since _ _ _ and mediastinal veins are now mildly dilated . this could be a function of the end of positive pressure ventilator support following tracheal extubation . clinical correlation advised . right lung is clear . residual opac ##ification in the left lower lobe which has improved over the past several days could be due to ate ##lec ##ta ##sis and residual edema . if there is any pleural effusion , is small , on the left . no pneumothorax . right pic line ends in the low sv ##c .
pred: 3. correct value: 2
lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are unremarkable .
pred: 2. correct value: 0
bib ##asi ##la ##r opac ##ities , likely reflecting ate ##lec ##ta ##sis although aspiration or pneumonia cannot be excluded in the right clinical setting .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
worsening bib ##asi ##la ##r air ##space opac ##ities concerning for progression of pneumonia .
pred: 1. correct value: 0
again seen is a dilated loops of small bowel and free air under the hemi ##di ##aph ##ragm ##s as described on the abdominal film . the ng tube tip is in the distal esophagus . this should be advanced . the lungs are clear . the cardiac and mediastinal sil ##hou ##ettes are normal notification : dr . _ _ _ discussed with dr . _ _ _ at _ _ _ : 02 on _ _ _ by telephone recommendation ( s ) : recommend advancing ng tube
pred: 3. correct value: 0
the tip cannot be localized on this view due to overlying pace ##r leads . these findings were communicate ##d to the iv nursing team at 11 : 30 a . m . by phone .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . no displaced rib fractures are seen . if there is continued concern for a rib fracture , consider a dedicated rib series .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient was intu ##ba ##ted . the tip of the endotracheal tube is at the orifice of the right main bronch ##us . the tube needs to be withdrawn by at least 2 - 3 cm . at the time of dict ##ation and observation , the referring physician _ _ _ . _ _ _ was page ##d for notification . findings were discussed _ _ _ min later over the telephone . a nas ##ogastric tube has also been placed . the tube is coiled in the stomach , the tip points towards the gastroesophageal junction . no pneumothorax . low lung volumes persist . moderate ate ##lec ##ta ##sis at the lung bases . mild cardio ##me ##gal ##y .
pred: 3. correct value: 1
left lower lobe collapse is unchanged since at least _ _ _ accompanied by increasing moderate left pleural effusion . mild pulmonary edema and moderate right pleural effusion have increased since _ _ _ and _ _ _ . right jugular line ends in the upper sv ##c , left pic line in the lower sv ##c . no pneumothorax . severe left ##ward mediastinal shift precludes assessment of cardiac size , probably not greatly enlarged .
pred: 3. correct value: 1
status post endotracheal intubation . no evidence of acute cardiopulmonary disease .
pred: 3. correct value: 0
chest tube present at right lung base . no pneumothorax detected .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . lines and tubes as described . of note , the side ##port of the right chest tube lies outside the chest wall . 2 . left lower lobe collapse and / or consolidation . 3 . no pneumothorax identified at present . subcutaneous emphysema noted .
pred: 3. correct value: 0
ng tube tip iso ##ut of view , below the diaphragm . wide ##ning of the mediastin ##um has minimally improved . dist ##ention of the stomach has improved . no other interval change from prior study .
pred: 3. correct value: 0
1 . interval improvement in left lower lobe ate ##lec ##ta ##sis . 2 . endotracheal tube terminate ##s 6 . 7 cm above the car ##ina . recommend inserting the endotracheal tube far ##ther by several cm for more optimal positioning . recommendation ( s ) : insert endotracheal tube far ##ther in by several cm . notification : the findings and recommendations were comm ##uin ##cat ##ed to dr . _ _ _ by dr . _ _ _ _ _ _ text _ _ _ on _ _ _ at 11 : 04 am , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
the tip of the do ##bh ##off tube projects below the level of the diaphragm ##s but beyond the field of view of this radiograph . no significant interval change in the pulmonary edema and large right pleural effusion with subj ##acent ate ##lec ##ta ##sis / consolidation .
pred: 1. correct value: 0
1 . stre ##ak ##y bib ##asi ##la ##r air ##space opac ##ities are new in the interval , concerning for aspiration or infection . 2 . interval improvement in extent of pneum ##omed ##ias ##tin ##um . similar degree of extensive subcutaneous emphysema , and moderate size left basal lateral hydro pneumothorax . 3 . emphysema .
pred: 3. correct value: 0
as compared to the previous radiograph , the known pleural lesion appears slightly smaller , given a different patient position . as second left lateral pleural lesion , likely reflecting in capsul ##ated pleural fluid , appears to be new . the ate ##lec ##ta ##sis at the left lung bases is slightly increased . unchanged normal appearance of the heart and of the right lung .
pred: 3. correct value: 2
in comparison with the study _ _ _ _ _ _ , there appears to be no appreciable change in the appearance of the stent in the left bronchial system . the peri ##hi ##la ##r opac ##ifications have decreased , especially on the right .
pred: 1. correct value: 0
previous pulmonary vascular congestion has improved since _ _ _ and lung volumes have increased although there is still substantial right lower lobe ate ##lec ##ta ##sis . moderate cardio ##me ##gal ##y is stable . there is no pulmonary edema . pleural effusion ##s are small if any .
pred: 3. correct value: 1
feeding tube in place . no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process
pred: 1. correct value: 0
pulmonary vascular congestion .
pred: 1. correct value: 0
as compared to the previous radiograph , the monitoring and support devices are in unchanged position . both the left and the right lung appears better ventilated than on the previous image . however , a right pleural effusion with subsequent right basilar ate ##lec ##ta ##sis persists . the size of the cardiac sil ##hou ##ette remains within normal ranges . no parenchymal opac ##ities have newly appeared . no evidence of pneumothorax .
pred: 3. correct value: 1
the tip of the trache ##ostomy tube is 5 . 2 cm above the car ##ina , appropriately site ##d . there is a right sided central venous line with distal tip in the mid sv ##c . low lung volumes are present . lungs are grossly clear without focal consolidation , pleural effusion ##s , or pneum ##otho ##ra ##ces . there is no pulmonary edema . heart size and mediastinal structures are within normal limits . bony structures are intact .
pred: 3. correct value: 2
1 . new endotracheal tube terminate ##s 3 . 5 cm above the car ##ina . enteric tube terminate ##s below the diaphragm . 2 . worsened pulmonary edema since the study 5 hours prior with bilateral pleural effusion ##s and adjacent opac ##ities , which could represent ate ##lec ##ta ##sis , infection , or aspiration .
pred: 3. correct value: 0
there is new opac ##ity at the left upper lung , suspicious for pneumonia . bilateral moderate pleural effusion ##s are increased from prior .
pred: 3. correct value: 0
et tube tip is 5 cm above the car ##inal . ng tube tip passes below the diaphragm termin ##ating in the stomach . cardio ##me ##gal ##y is substantial . mediastinal wide ##ning is unchanged . large bilateral pleural effusion ##s , right more than left are unchanged . mild vascular congestion is noted but no overt pulmonary edema is seen .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
mild pulmonary edema .
pred: 1. correct value: 0
known right lower chest rib fractures not well demonstrated radiographic ##ally . no pneumothorax detected . bib ##asi ##la ##r ate ##lec ##ta ##sis , minimal on the right , with possible trace right pleural fluid .
pred: 1. correct value: 0
subtle opac ##ity right lung base is likely ate ##lec ##ta ##sis , however a small consolidation cannot be excluded .
pred: 3. correct value: 0
these findings were discussed with dr . _ _ _ by dr . _ _ _ by telephone at 9 : 47 a . m . on _ _ _ .
pred: 1. correct value: 0
brach ##io ##cephal ##ic vein .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . the patient has been ext ##ubated and the nas ##ogastric tube is removed . the other monitoring and support devices are in unchanged position . mild cardio ##me ##gal ##y without pleural effusion ##s or pulmonary edema .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is increased opac ##ification at the left base with poor definition of the hemi ##di ##aph ##ragm , consistent with volume loss in the left lower lobe and small pleural effusion . although no definite consolidation , this would be difficult to unequiv ##ocally exclude in the appropriate clinical setting , especially in the absence of a lateral view
pred: 3. correct value: 0
prior exam in this patient with known extensive lung cancer . no definite signs of superimposed pneumonia in the right lung .
pred: 1. correct value: 0
patchy bib ##asi ##la ##r opac ##ities , most consistent with ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no pneumothorax .
pred: 1. correct value: 0
mild to moderate pulmonary edema . an underlying atypical infectious process is not excluded in the correct clinical setting and follow up radiographs after di ##uresis are recommended .
pred: 1. correct value: 0
pneumonia . recommend follow - up to resolution .
pred: 1. correct value: 0
bilaterally , which could be due to aspiration or infection . dedicated pa and lateral views may be helpful for further evaluation . possible also focal patchy opac ##ity at the lateral left upper lobe , which could also be related to infection .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there are no focal consolidation ##s , pleural effusion , or pulmonary edema . no definite interstitial abnormalities are seen . if there is persistent concern , a high - resolution ct would be more sensitive . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 0
stre ##ak ##y left basilar opac ##ity , likely ate ##lec ##ta ##sis . no pulmonary edema .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
moderate cardio ##me ##gal ##y and mild pulmonary vascular eng ##or ##ge ##ment are unchanged . peri ##bronchial opac ##ification at the right and left lung bases has increased , could be due to ate ##lec ##ta ##sis alone or aspiration . left ##ward displacement of the trachea in the neck is new or newly apparent . a soft tissue contour to the right of midline at the thoracic inlet is unexplained . patient should be evaluated clinically for possibility of abscess or hematoma if line placement attempt was made . i discussed these findings with the caring physician by telephone at 10 : 20 a . m . when the chest radiograph was reviewed .
pred: 3. correct value: 1
normal lung volumes . borderline size of the cardiac sil ##hou ##ette . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 3. correct value: 1
moderate left and small right pleural effusion . mild interval improvement of pulmonary edema .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no change .
pred: 1. correct value: 0
small persistent bilateral effusion ##s . no confluent consolidation .
pred: 1. correct value: 0
effusion and asymmetric opac ##ification involving the right hemi ##th ##orax is likely related to progressive changes related to her known disease process / and or a component of asymmetric edema .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
nearly resolved bilateral pleural effusion ##s . aside from small foci of linear ate ##lec ##ta ##sis , lungs are clear . a linear radio ##den ##si ##ty projecting just inferior to the left mainst ##em bronch ##us may be post procedural .
pred: 3. correct value: 0
the tip of the right pic ##c line has migrated more proximal ##ly and is now within the proximal sv ##c . there is unchanged cardio ##me ##gal ##y . mediastinal wires are seen . there is promin ##ence of the pulmonary interstitial marking ##s and ate ##lec ##ta ##sis at the lung bases . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 1
new haz ##y opac ##ity in the region of the right cardio ##ph ##ren ##ic angle and lower right chest wall - - _ _ _ appearance is more suggestive of a new small effusion than of focal consolidation . attention to this area on followup films is requested . no left effusion . otherwise , no focal opac ##ities . mild vascular plethora , probably slightly increased . subs ##eg ##mental ate ##lec ##ta ##sis left base . small nodular density at the right lung base laterally is obscure ##d , incidental ##ly , on today ' s exam . please see previous report for relevant recommendations .
pred: 3. correct value: 0
1 . there continues to be a large pleural effusion surrounding the right lung with minimal change in size of the effusion and degree of lung aer ##ation . there is a small - to - moderate layer ##ing left effusion . overall cardiac and mediastinal contours are difficult to assess due to the extensive effusion ##s and the technique of the examination . no obvious pneumothorax , although the patient is only semi - erec ##t on the study , which would lower the sensitivity to detect pneumothorax .
pred: 3. correct value: 0
significant interval change compared with _ _ _ at 4 : 16 a . m .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
cardio ##me ##gal ##y is substantial , unchanged . mediastinal sil ##hou ##ette is stable . small bilateral pleural effusion is present . there is no pneumothorax . post stern ##otomy wires are unremarkable .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
interval intubation and placement of esophageal catheter with tubes in satisfactory positions .
pred: 2. correct value: 0
no previous images . cardiac sil ##hou ##ette is within normal limits and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
no pneumothorax after chest tube removal .
pred: 1. correct value: 0
large bilateral pleural effusion ##s are unchanged . heart size and mediastin ##um are similar including cardio ##me ##gal ##y . patient continues to be in moderate to severe pulmonary edema .
pred: 3. correct value: 1
1 . decreased right apical pneumothorax . 2 . small pleural effusion ##s with worsening adjacent bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
no previous images . cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia . scoliosis of the thoracic spine is convex to the right . specifically , no evidence of hil ##ar or mediastinal lymphadenopathy .
pred: 3. correct value: 2
no acute cardiopulmonary process . bilateral ate ##lec ##ta ##sis .
pred: 1. correct value: 0
large right upper lobe mass with a pleural component is concerning for primary lung cancer . recommend ct chest for further evaluation .
pred: 3. correct value: 0
a chest ct on _ _ _ : right upper lobe lung nodule reported as new on _ _ _ chest ct can be seen on _ _ _ chest radiograph , projecting over the second rib , and has subsequently invol ##uted . also resolved since _ _ _ is the mass - like lesion in the right middle lobe in the region of prior surgery . the scattered peri ##bronchial ground - glass abnormalities in the lung seen on _ _ _ might not be readily apparent on conventional chest radiographs , but they certainly have not worsened . overall , there are no radiographic findings to suggest intrath ##oracic infection , although of course , ct scanning would be more sensitive in their detection . heart size is normal . there is no appreciable pleural effusion .
pred: 3. correct value: 2
no acute intrath ##oracic process
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . multifocal subs ##eg ##mental pulmonary ate ##lec ##ta ##sis is worse , and low lung volumes exagger ##ate pulmonary vascular congestion and moderate cardio ##me ##gal ##y . patient could be on the ver ##ge of pulmonary edema . no appreciable pleural effusion . ind ##welling , right trans ##jug ##ular dialysis catheter ends in the low right atrium .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the trache ##ostomy tube is unchanged . although the opaque portion of the do ##bh ##off tube is barely seen on this study , it it again appears to stra ##dd ##le the esophag ##ogastric junction . haz ##y opac ##ification at the bases again suggests layer ##ing pleural effusion ##s with compressive basilar ate ##lec ##ta ##sis .
pred: 3. correct value: 0
right lung base is still elevated by a combination of subp ##ul ##mon ##ic pleural effusion , elevation of the right hemi ##di ##aph ##ragm . there is no change in multiple lung nodules , the largest of which abut ##s the left heart border , no change in small left pleural effusion or region of consolidation in the posterior segment of the right upper lobe , probably ate ##lec ##ta ##sis . of greater concern to me is a slight increase in cal ##iber of the az ##yg ##os vein , in a patient with documented pericardial effusion . dr . _ _ _ was page ##d at 10 a . m . , 1 minute following recognition of the findings which we discussed by telephone 2 minutes later .
pred: 3. correct value: 0
1 . right apical opac ##ity is improved , likely resolving hematoma . 2 . right apical pneumothorax has resolved .
pred: 1. correct value: 0
new right upper lung opac ##ity may reflect pneumonia . other etiologies for focal opac ##ities are not excluded . followup radiograph is recommended in 6 weeks after the completion of treatment to insu ##re resolution and rule out possibility of a mass . recommendation ( s ) : followup radiograph is recommended in 6 weeks after the completion of treatment to insu ##re resolution and rule out possibility of a mass .
pred: 3. correct value: 0
known right hil ##ar lymphadenopathy and right lateral pleural mass better assessed on ct . no definite new focal consolidation . no pulmonary edema .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
pneumonia . results were discussed with _ _ _ ' s assistant at 1 : 20 p . m . on _ _ _ via telephone by dr . _ _ _ at the time the findings were discovered .
pred: 1. correct value: 0
radiographs and postoperative chest radiographs , _ _ _ and _ _ _ : small bilateral pleural effusion ##s have increased since _ _ _ . there is no pneumothorax . heart size is normal . aside from relatively mild bib ##asi ##la ##r ate ##lec ##ta ##sis , lungs are clear .
pred: 3. correct value: 2
most recently _ _ _ : distortion of the right anterior diaphragmatic interface is responsible for haz ##y opac ##ification at the base of the right hemi ##th ##orax . lungs are clear . left lung is hyper ##infl ##ated , and there may be a diaphragmatic pleural calcification . explanation for air and fluid collections in the right upper quadrant is presumably migration of the intestinal tract following hepatic resection in that area , but this is not a complete evaluation of that region which should be considered from a clinical stand ##point to see if additional imaging is necessary . post - traumatic rib coal ##ition and pleural thickening is noted along the left anter ##olateral chest wall . heart size is normal . there is no left pleural effusion .
pred: 3. correct value: 2
compared to prior chest radiographs _ _ _ through _ _ _ . moderate left pleural effusion and left lower lobe ate ##lec ##ta ##sis are unchanged . mild to moderate cardio ##me ##gal ##y has worsened , pulmonary vasculature is more eng ##or ##ged and there is new interstitial edema . no pneumothorax . et tube , left pic line , and right subcl ##avi ##an central venous infusion port are in standard placement ##s . an esophageal drainage tube passes into the stomach and out of view .
pred: 3. correct value: 1
large right pleural effusion has not changed appreci ##ably , still shifting the mediastin ##um moderately to the left and coll ##apsing much if not all of the right middle and lower lobes . mild edema in the left lung has worsened since _ _ _ . there is no left - sided consolidation , pleural effusion or pneumothorax . feeding tube passes into the stomach and out of view . right internal jugular line ends in the mid sv ##c .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has been intu ##ba ##ted . the tip of the endotracheal tube projects 4 . 6 cm above the car ##ina . the right pic ##c line is unchanged . unchanged moderate cardio ##me ##gal ##y . ate ##lec ##ta ##sis of the left lower lobe and moderate left pleural effusion .
pred: 3. correct value: 1
trache ##ostomy is in place . cardio ##medi ##astin ##al sil ##hou ##ette is unchanged . right internal jugular line tip is at the level of lower sv ##c . no appreciable pleural effusion demonstrated but small amount of fluid is most likely present . there is no pneumothorax . overall no substantial change since the prior study demonstrated .
pred: 3. correct value: 0
widespread bronchi ##ect ##asis and peri ##bronchial infiltr ##ative abnormalities , generally improved in the upper lungs , worsened in the right lower lobe . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes are normal and there is no evidence pleural effusion . recommendation ( s ) : monitoring with chest ct is more reliable for focal findings , but plain radiography is sufficient for overall progression of disease is and new developments . _ _ _ , md
pred: 3. correct value: 0
as compared to the previous radiograph , there is a newly appeared extensive left pleural effusion that opac ##ifies the entire left hemi ##th ##orax . the effusion causes displacement of the mediastin ##um to the right . in addition , there is enlargement of the right mediastin ##um , consistent with the known history of non - small cell lung cancer . the ventilated areas of the right lung are unremarkable . at the time of dict ##ation and observation , the referring physician _ _ _ . _ _ _ was page ##d and the findings were discussed _ _ _ min later over the telephone , at 08 : 44 , on the _ _ _ .
pred: 3. correct value: 0
no evidence of pneumonia or overt pulmonary edema .
pred: 1. correct value: 0
comparison to _ _ _ . no relevant change . of the clamping of the right chest tube , the _ _ _ of the known right pneumothorax are stable , in the range of 8 - 10 mm . no evidence of tension . mild cardio ##me ##gal ##y . basal areas of left lower lobe ate ##lec ##ta ##sis . the right central venous access line is in constant position .
pred: 3. correct value: 1
consolidation in the left lower lobe on _ _ _ could have been collapse or pneumonia , accompanied by small left pleural effusion . today with mild pulmonary edema , mediastinal and pulmonary vascular congestion , the small left pleural effusion has increased and the left lower lobe consolidation has not cleared . heart is still moderately enlarged .
pred: 1. correct value: 0
increased size of moderate right pleural effusion with associated right basilar ate ##lec ##ta ##sis . similar appearance of the right peri ##hi ##la ##r mass .
pred: 3. correct value: 0
minimal pulmonary vascular congestion .
pred: 1. correct value: 0
unchanged appearance of low lung volumes , bilateral interstitial opac ##ities consistent with known pulmonary fibrosis is noted . there is no evidence of new focal consolidation to suggest infectious process . no interval development of pleural effusion or pneumothorax is seen .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . minimal opac ##ification at the right lung base , likely ate ##lec ##ta ##sis . no definite evidence of pneumonia . 2 . hyper ##infl ##ation and coarse interstitial marking ##s , likely due to interstitial lung disease .
pred: 3. correct value: 0
clinical setting could represent a very early / mild pneumonia .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary pathology .
pred: 1. correct value: 0
patchy opac ##ities in the lung bases bilaterally , right greater than left . while this could be secondary to multifocal pneumonia , a right upper lobe mass cannot be excluded on this study and ct can be considered for further assessment . _ _ _ were d / w dr . _ _ _ , by dr . _ _ _ by telephone at 5 : _ _ _ p on the day of the exam .
pred: 1. correct value: 0
tip of the newly placed intra - aortic catheter pump is midw ##ay between the upper margin of the left main bronch ##us and the apex of the aortic arch . sw ##an - gan ##z catheter loops in the right atrium and barely crosses the tricuspid valve . nas ##ogastric tube passes into the stomach , where it probably loops , termin ##ating in the gastric fundus . right lower lobe ate ##lec ##ta ##sis has improved , dense consolidation in the left lower lobe , most commonly ate ##lec ##ta ##sis , but conceiv ##ably pneumonia , has not . moderate cardio ##me ##gal ##y is slightly worse , but there is little if any pulmonary edema . small - to - moderate left pleural effusion is unchanged and there is no pneumothorax . clinical service was notif ##ied by telephone at 8 : 25 a . m .
pred: 3. correct value: 1
1 . small left pleural effusion and left lower lobe collapse . 2 . left hemi ##di ##aph ##ragm is obscure ##d . notification : updated impression was discussed with dr . _ _ _ by dr . _ _ _ _ _ _ telephone at 15 : 30 on _ _ _ , _ _ _ min after discovery .
pred: 1. correct value: 0
several contiguous posterior left rib ##s not seen raising possibility of destructive process - please correlate with any prior surgical history . if none , ct scan is advised . cardio ##me ##gal ##y without definite superimposed acute cardiopulmonary process . discussed with dr . _ _ _ . patient has history of prior rib resection .
pred: 3. correct value: 1
though patient rotation limits evaluation .
pred: 1. correct value: 0
there has been interval decrease in the amount of pneum ##oper ##ica ##rd ##ium . there still small amount present . there is volume loss at the bases . there small bilateral effusion ##s . the heart continues to be severely enlarged there is mild pulmonary vascular redistribution . the upper lungs are relatively clear .
pred: 3. correct value: 1
no significant interval change .
pred: 1. correct value: 0
vag ##ue opac ##ity at the left base , ate ##lec ##ta ##sis versus pneumonia ; correlation with pulmonary symptoms is recommended , if any . short - term follow - up radiographs may be helpful if there is clinical concern for developing infectious process .
pred: 1. correct value: 0
as compared to the previous radiograph , the lung volumes continue to be very low . moderate cardio ##me ##gal ##y and small bilateral pleural effusion ##s persists . mild to moderate pulmonary edema . a parenchymal opac ##ity and the level of the left hil ##us should be kept on the close radiographic observation , to exclude the possibility of developing pneumonia .
pred: 3. correct value: 1
no comparison . the lung volumes are normal . mild scoliosis of the thoracic spine . no pneumonia , no pulmonary edema , no pleural effusion ##s . normal size of the heart . normal appearance of the hil ##ar and mediastinal contours .
pred: 3. correct value: 2
severe right lower lobe ate ##lec ##ta ##sis continues to worsen since _ _ _ , now following tracheal extubation . pulmonary vasculature is eng ##or ##ged but there is no edema and pleural effusion ##s are small if any . moderate cardio ##me ##gal ##y is long ##standing . no pneumothorax .
pred: 3. correct value: 1
bib ##asi ##la ##r linear ate ##lec ##ta ##sis and a small left pleural effusion . rest of the findings remain unchanged compared to the prior report .
pred: 3. correct value: 0
low lung volumes with bib ##asi ##la ##r ate ##lec ##ta ##sis and mild pulmonary vascular congestion . no subd ##ia ##ph ##ragm ##atic free air .
pred: 1. correct value: 0
per report could reflect a malignancy . please correlate clinically and with prior imaging as available . if needed a ct may be obtained to further assess on a non - emergent basis .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change in the substantial bilateral pleural effusion ##s with compressive ate ##lec ##ta ##sis at the bases . central catheter is unchanged .
pred: 1. correct value: 0
represents ate ##lec ##ta ##sis / scarring . however , if the patient has been treated for underlying pneumonia since the prior study , consider chest ct for further evaluation for confirmation , as question early pneumonia has been raised in the past in this location . there is minimal pulmonary vascular congestion .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are essentially unchanged . the lung volumes have slightly improved . continued enlargement of the cardiac sil ##hou ##ette with haz ##y opac ##ification at the left consistent with layer ##ing effusion and basilar ate ##lec ##ta ##tic changes . no evidence of congestive failure an the right lung is essentially clear .
pred: 3. correct value: 1
mild pulmonary edema , progressive severe cardio ##me ##gal ##y , and more mediastinal venous eng ##or ##ge ##ment have developed indicating cardiac decompens ##ation since _ _ _ . pleural effusion is presumed , but not large . no pneumothorax .
pred: 3. correct value: 1
no significant interval change in mild pulmonary edema , small bilateral pleural effusion ##s , and bib ##asi ##la ##r subs ##eg ##mental ate ##lec ##ta ##sis .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip not identified . endotracheal tube and left internal jugular central line are unchanged in position . overall cardiac and mediastinal contours are stably enlarged . there is interval worsening of a bilateral interstitial process , likely reflecting mild - to - moderate pulmonary edema . in addition , there are layer ##ing bilateral effusion ##s with patchy bib ##asi ##la ##r air ##space disease , left greater than right , likely reflecting compressive ate ##lec ##ta ##sis , although pneumonia or aspiration should also be considered . no pneumothorax .
pred: 3. correct value: 0
1 . moderate pulmonary edema with bilateral small pleural effusion ##s , left greater than right . 2 . bib ##asi ##la ##r ate ##lec ##ta ##sis , pneumonia must be excluded in the proper clinical setting .
pred: 3. correct value: 0
interval placement of tracheal stent . no new pneumothorax .
pred: 1. correct value: 0
thickening are concerning for a developing pneumonia in this region .
pred: 3. correct value: 0
by ate ##lec ##ta ##sis or ate ##lec ##ta ##sis ; pneumonia is doubt ##ful , although difficult to entire ##dl ##y exclude .
pred: 1. correct value: 0
dr . _ _ _ _ _ _ the findings with _ _ _ ( iv nurse ) by phone at 2 : 15 p . m . on _ _ _ .
pred: 1. correct value: 0
ng tube now terminate ##s in the gastric fundus . discussed with dr . _ _ _ by _ _ _ in person
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been interval placement of a left subcl ##avi ##an port - a - cath at an outside facility . the tip extends to the mid to lower portion of the sv ##c . no acute cardiopulmonary disease .
pred: 3. correct value: 0
as compared to the previous radiograph , the lung volumes have slightly increased , potentially as an expression of improved ventilation . minimal ate ##lec ##ta ##sis at the right lung basis and plate ##li ##ke ate ##lec ##ta ##sis of the left lung bases , however , persist . currently there is no evidence for pulmonary edema or pneumonia . moderate cardio ##me ##gal ##y is unchanged . mild tort ##uo ##si ##ty of the thoracic aorta .
pred: 3. correct value: 1
moderate cardio ##me ##gal ##y and mild pulmonary edema , slightly progressed since prior .
pred: 0. correct value: 1
pneumonia .
pred: 1. correct value: 0
comparison to _ _ _ . no relevant change is noted . low lung volumes . moderate cardio ##me ##gal ##y with enlargement of the left ventricle . moderate elongation of the descending aorta . stable position of the right internal jugular vein catheter . no overt pulmonary edema . no pleural effusion ##s .
pred: 3. correct value: 1
vag ##ue opac ##ity in the left lower lung likely reflect bronch ##ovascular crowding , difficult to exclude an early pneumonia in the correct clinical setting .
pred: 1. correct value: 0
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiographs . no pleural effusion .
pred: 1. correct value: 0
known bilateral apical cavities / myc ##etom ##as is suspicious for recurrence of known asperg ##il ##us infection , though other pulmonary infections including pneumonia cannot be fully excluded . depending on clinical circumst ##ance further assessment by ct can be obtained . this was discussed with dr . _ _ _ by dr . _ _ _ at _ _ _ on _ _ _ by phone .
pred: 1. correct value: 0
no infiltrates .
pred: 1. correct value: 0
1 . endotracheal tube has its tip at the thoracic inlet . right internal jugular central line is unchanged in position . a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip not identified . there are stable small bilateral effusion ##s , left greater than right , with some associated patchy air ##space process , likely reflecting compressive ate ##lec ##ta ##sis . no evidence of pulmonary edema . overall cardiac and mediastinal contours are stable . no large pneumothorax is appreciated , although the sensitivity to detect a pneumothorax is diminished given semi - supine technique . when compared to the prior study , there has been slight interval improvement in aer ##ation in both lungs .
pred: 3. correct value: 0
no change .
pred: 1. correct value: 0
lung volumes are generally low . a very mild peri ##hi ##la ##r haz ##e could represent mild edema , but the major abnormalities are areas of subs ##eg ##mental ate ##lec ##ta ##sis in both lungs , moderate on the right , mild on the left . there is no appreciable pleural effusion . heart size is normal . worsening hypoxia could be due to unexpected pulmonary embol ##i or progression of hepatic pulmonary syndrome . i see no other good explanation .
pred: 3. correct value: 2
hyper ##infl ##ated lungs with marker promin ##ence of interstitial marking ##s and bib ##asi ##la ##r linear ate ##lec ##ta ##sis . no lob ##ar consolidation . rest of the findings are unchanged compared to the prior radiograph .
pred: 2. correct value: 0
low lung volumes . left base opac ##ity seen laterally ; differential diagnosis includes infection or ate ##lec ##ta ##sis , new since the prior study from _ _ _ .
pred: 3. correct value: 0
moderate pulmonary edema with probable trace bilateral pleural effusion ##s , potentially superimposed on a background of chronic interstitial lung disease . moderate size hi ##atal hernia .
pred: 3. correct value: 0
endotracheal tube has been removed . the right subcl ##avi ##an catheter and feeding tube are unchanged in position . heart size is within normal limits . there is ate ##lec ##ta ##sis at the lung bases . there is no pulmonary edema or pneum ##otho ##ra ##ces .
pred: 1. correct value: 2
intrath ##oracic metastatic disease .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
limited exam without definite acute cardiopulmonary process .
pred: 1. correct value: 0
a newly placed endotracheal tube ends at the thoracic inlet . dual - channel right supra ##cl ##avi ##cu ##la ##r central venous dialysis catheter ends low in the sv ##c . nas ##ogastric tube passes into the stomach and out of view . no pneumothorax or pleural effusion . moderate - to - severe enlargement of the cardiac sil ##hou ##ette is long ##standing . pulmonary edema which worsened from _ _ _ to _ _ _ has subsequently improved , but is mild and slightly worse compared to earlier in the day .
pred: 3. correct value: 1
low inspiratory volumes . slight increase in opac ##ities at the left lung base .
pred: 1. correct value: 0
in comparison study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . hypere ##x ##pan ##si ##on of the lungs with flatten ##ing hemi ##di ##aph ##ragm ##s suggests chronic pulmonary disease , but there is no evidence of acute pneumonia , vascular congestion , or pleural effusion . mild fibrotic changes are again seen at the right base .
pred: 3. correct value: 0
compared to prior chest radiograph _ _ _ . volume loss and right peri ##hi ##la ##r consolidation in the right hemi thorax have decreased . postoperative left pleural drainage tube in place . small pneumothorax at the apex and base of the left lung associated with new subcutaneous emphysema in the left lower chest wall . normal cardio ##medi ##astin ##al sil ##hou ##ette .
pred: 1. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there are no focal consolidation ##s , pleural effusion , or pulmonary edema . there are no pneum ##otho ##ra ##ces . bony structures are intact .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process . heart size is normal .
pred: 1. correct value: 2
persistent , moderate right - sided pneumothorax .
pred: 1. correct value: 0
1 . the patient is markedly rotated on the current examination . the endotracheal tube has its tip 4 . 4 cm above the car ##ina . a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip not identified . a right internal jugular central line is unchanged in position with its tip in the proximal to mid sv ##c . 2 . there is worsening bilateral air ##space process , likely pulmonary edema with increasing consolidation at the left base likely reflecting compressive ate ##lec ##ta ##sis in the setting of a pleural effusion . a smaller right effusion is also likely evident . a right - sided dual - lead pace ##r remains in place with its leads termin ##ating over the expected location of the right atrium and right ventricle respectively . no pneumothorax appreciated . heart remains enlarged .
pred: 3. correct value: 0
in comparison with the study _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . the cardiac sil ##hou ##ette is at the upper limits of normal in size or mildly enlarged . no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
loc ##ulated pleural effusion . otherwise , no interval change compared with prior exam .
pred: 1. correct value: 0
no radiographic evidence pneumonia .
pred: 1. correct value: 0
ng tube tip is in the stomach . right internal jugular line tip is at the level of mid sv ##c . bilateral pleural effusion ##s are present . no pneumothorax .
pred: 3. correct value: 0
comparison to _ _ _ . status post left upper lobe wedge resection . the pre - existing left apical _ _ _ medial pneumothorax has slightly increased in extent and severity . there is an air - fluid level seen at the bases of the left hemi thorax . no evidence of tension . normal appearance of the heart and of the right lung .
pred: 3. correct value: 2
small right apical pneumothorax , shown on the chest ct _ _ _ , has not changed the past several days . basal pleural drain in place . no appreciable right pleural effusion . severe consolidation right upper lobe has improved since _ _ _ , not subsequently . mild edema and severe cardio ##me ##gal ##y worsened since _ _ _ . small left pleural effusion or pleural scarring is unchanged . feeding tube passes into the stomach and out of view . left pic line ends in the upper sv ##c . no left
pred: 3. correct value: 1
there has been marked interval worsening of right mid and right lower lobe consolidation ##s consistent with pneumonia . left lower lobe larger of ate ##lec ##ta ##se ##s is minimally improved . mild vascular congestion is mildly increased . left pleural effusion is probably unchanged allowing the difference in positioning of the patient . ng tube tip is in the stomach . right ij catheter tip is in the upper sv ##c . there is no evident pneumothorax . cardiac size cannot be evaluated
pred: 3. correct value: 1
1 . new haz ##y opac ##ity involving the right lung with numerous air - fluid levels superior ##ly in the region of recent right upper lobe ##ct ##omy . this could represent infection with associated loc ##ulated fluid , however ct would be pr ##ude ##nt to exclude emp ##ye ##ma . 2 . no radiographic evidence of pneumothorax . 3 . diminishing subcutaneous emphysema .
pred: 3. correct value: 0
pulmonary edema . small left pleural effusion .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
persistent small left pleural effusion . otherwise no acute cardiopulmonary process .
pred: 3. correct value: 0
1 . interval right middle lobe and right lower lobe collapse . 2 . endotracheal tube terminate ##s 4 . 3 cm from the car ##ina . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ _ _ _ , m . d . on the telephone on _ _ _ at 5 : 09 pm , 50 minutes after discovery of the findings .
pred: 3. correct value: 0
similar appearance of a right pleural effusion and right lower lobe consolidation .
pred: 3. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process . no displaced rib fracture is seen , however , please note that dedicated rib series or chest ct are more sensitive .
pred: 2. correct value: 0
or pulmonary edema .
pred: 1. correct value: 0
moderate right pleural effusion has increased since _ _ _ . mediastin ##um midline . right upper lobe well expanded . the remainder the postoperative for a right lung , if any , is air ##less left lung grossly clear . no appreciable right pneumothorax . extensive subcutaneous emphysema in the right chest wall and neck developed on _ _ _ , subsequently red ##istr ##ib ##uted but unchanged in volume .
pred: 3. correct value: 0
no significant change since comparison exam . persistent bilateral pleural effusion ##s left greater than right .
pred: 3. correct value: 0
persisting but decreased pulmonary edema . a trace right pleural effusion is likely present .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there are even lower lung volumes . this probably accounts for the apparent opac ##ification at the right base , which most likely represents may relate to crowding of vascular structures . _ _ _ , md _ _ _ = _ _ _
pred: 3. correct value: 0
as compared to the previous radiograph , all monitoring and support devices , with the exception of the right internal jugular venous introduction sheet have been removed . lung volumes have increased , likely reflecting improved ventilation . normal appearance of the postoperative cardiac sil ##hou ##ette . small to moderate bilateral pleural effusion ##s . areas of apical lateral pleural thickening bilaterally are constant in appearance . moderate pulmonary edema . moderate retro ##car ##di ##ac ate ##lec ##ta ##sis .
pred: 3. correct value: 2
underlying interstitial lung disease without definite superimposed acute process .
pred: 1. correct value: 0
pulmonary edema and central venous congestion improved between _ _ _ and _ _ _ however edema has recurr ##ed accompanied by increasing cal ##iber to hil ##ar mediastin ##um pulmonary vessels . moderate cardio ##me ##gal ##y is remained the same . the suggestion of new consolidation in the right lower lobe very could be due to dependent edema and ate ##lec ##ta ##sis but should be monitored closely for the possibility of pneumonia . no pneumothorax .
pred: 3. correct value: 1
left basilar ate ##lec ##ta ##sis . increased conspic ##uity of a right poster ##olateral eighth rib fracture . no new fractures .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . no displaced rib fractures identified . if there is continued concern for rib fracture , then a dedicated rib series is recommended .
pred: 1. correct value: 0
no pneumothorax or increase in small to moderate residual right pleural effusion since _ _ _ : 00 following removal of the right pleural drainage tube . right pic line ends in the region of the superior cav ##oa ##trial junction . mild pulmonary edema , seen best in the left lung , unchanged . stable postoperative appearance of the mediastinal sil ##hou ##ette including fluid - filled neo esophagus . pericardial calcification noted incidental ##ly .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
comparison to _ _ _ . no relevant change is noted . the position of the left chest tube is stable . the right upper lobe opac ##ity is stable in extent and severity . the opac ##ity needs to be monitoring until complete resolution . retro ##car ##di ##ac ate ##lec ##ta ##sis is slightly improved . no pleural effusion ##s .
pred: 3. correct value: 0
right internal jugular line still ends low in the right atrium , no less than 3 cm beyond the superior cav ##oa ##trial junction . previous mild pulmonary edema has improved , left lower lobe collapse is unchanged . small bilateral pleural effusion ##s would not be detectable on this semi - erec ##t chest radiograph , previously layer ##ing posteriorly . mild cardio ##me ##gal ##y is stable . et tube is in standard placement . no pneumothorax .
pred: 3. correct value: 1
comparison to _ _ _ . moderate hi ##atal hernia . no chest wall abnormalities . no rib fractures . no pleural effusion ##s . no pneumothorax , no pulmonary edema or pneumonia . normal size of the heart .
pred: 3. correct value: 2
no active cardiopulmonary disease .
pred: 1. correct value: 0
1 . no evidence of acute cardiopulmonary process . left lower lobe ate ##lec ##ta ##sis . 2 . radiation changes in the right apex as well as chronic esophageal dilatation are unchanged since at least _ _ _ .
pred: 1. correct value: 0
no acute cardiopulmonary process . no intraperitoneal free air identified
pred: 2. correct value: 0
heart size and mediastin ##um are stable . there is a left intra hil ##ar opac ##ity , new as compared to the previous study and potentially might represent developing infectious process . no pleural effusion or pneumothorax is seen . attention to this area is recommended and preferably pa and lateral radiographs of the chest would be beneficial for pre size characterization .
pred: 2. correct value: 3
linear left basilar opac ##ity , potentially due to ate ##lec ##ta ##sis , however , superimposed infection cannot be excluded in the proper clinical setting . new 8 ##mm left basilar nodular opac ##ity , new from prior . non ##urge ##nt repeat with nip ##ple markers suggested as this could represent a nip ##ple shadow .
pred: 3. correct value: 0
no focal consolidation concerning for pneumonia .
pred: 1. correct value: 0
left pic ##c line is stable and in appropriate position . no acute cardiopulmonary process .
pred: 3. correct value: 0
interval advancement of the do ##bh ##off tube into the body of stomach .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
feeding tube has been partially withdrawn , now ends above the gastroesophageal junction and would need to be advanced at least 15 cm to move all the side port ##s into the stomach . left pic line ends in the mid to low sv ##c . right lung is clear . heart size is top - normal . small left pleural effusion has decreased since _ _ _ . there is no pneumothorax . left lower lobe ate ##lec ##ta ##sis worsened from _ _ _ to _ _ _ and has not improved .
pred: 3. correct value: 1
concerning for an early multifocal pneumonia .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient was intu ##ba ##ted . the tip of the endotracheal tube projects 3 . 5 cm above the car ##ina . moderate cardio ##me ##gal ##y persists . the other monitoring and support devices are in constant position . no pneumothorax or pleural effusion ##s . mild ate ##lec ##ta ##sis at the left lung bases . known calcified left hil ##ar lymph nodes .
pred: 3. correct value: 1
1 . left pic ##c in appropriate positioning . 2 . improving pulmonary edema .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
1 . extensive consolidation of the left upper lobe and ling ##ula , which was better characterized on the recent ct scan performed _ _ _ . no appreciable interval change . 2 . no pleural effusion ##s or cav ##itary lesions .
pred: 3. correct value: 0
comparison to _ _ _ . no relevant change . mild pulmonary edema . moderate cardio ##me ##gal ##y . no pleural effusion ##s . no pneumonia .
pred: 3. correct value: 1
diminished . there are linear areas of ate ##lec ##ta ##sis or scarring in both lungs , but several smaller irregular opac ##ities in the left mid and lower lung zones . i cannot tell whether these are areas of peri ##bronchial infiltration , even bronchi ##ect ##asis . any prior chest imaging should be obtained and ct scanning may ultimately be indicated . heart size is normal . there is no pleural effusion or evidence of central adeno ##path ##y .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
compared to prior chest radiographs since _ _ _ , most recently 12 : 57 today . this radiograph was taken following bronch ##oscopic extraction of bronchial secretions , and placement of an et tube in standard position . right middle lobe is partially aer ##ated , but there is still complete collapse of the upper and lower lobes . downward bul ##ging of the minor fis ##su ##re suggests either bleeding in the upper lobe or mid fis ##su ##ral pleural collection . solitary pig ##tail pleural drainage catheter is still in place . there is no pneumothorax . left lung shows expected vascular congestion but is otherwise clear . heart is unchanged , moderately enlarged . pulmonary arteries are chronically enlarged . right pic line ends close to the superior cav ##oa ##trial junction . recommendation ( s ) : chest ct scanning , with contrast agent if the patient can tolerate it , to localize fluid collections in the right hemi thorax , particularly blood , and assess the patency of the bronchial tree . notification : dr . _ _ _ reported the findings to dr _ _ _ by telephone on _ _ _ at 3 : 57 pm , _ _ _ min after the initial 2 pages placed immediately after discovery of the findings .
pred: 3. correct value: 0
ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no previous images . the cardiac sil ##hou ##ette is at the upper limits normal or mildly enlarged and there is evidence of elevated pulmonary venous pressure with small effusion ##s and ate ##lec ##ta ##tic changes at the bases . left subcl ##avi ##an pace ##r is in place with leads extending to the right atrium and apex of the right ventricle . no evidence of post procedure pneumothorax . suggestion of more coales ##cent area of opac ##ification at the right base could reflect developing consolidation in the appropriate clinical setting . there are surgical clips in the left axillary region , consistent with the clinical history of prior mastectomy .
pred: 3. correct value: 2
in comparison with the study of _ _ _ , there is increased opac ##ification at the right base , consistent with re - accumulation of pleural fluid and underlying compressive ate ##lec ##ta ##sis . increased retro ##car ##di ##ac opac ##ification with poor definition of the hemi ##di ##aph ##ragm is consistent with volume loss in the lower lobe and possible pleural fluid . there is some eng ##or ##ge ##ment of ill defined pulmonary vessels , consistent with some elevation of pulmonary venous pressure .
pred: 3. correct value: 0
improving left hydro pneumothorax following left upper lobe ##ct ##omy .
pred: 1. correct value: 0
no significant interval change .
pred: 1. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
in comparison with the study of _ _ _ the monitoring and support devices are stable . again there is scatter radiation relating to the size of the patient that is limiting the examination . the cardiac sil ##hou ##ette remains enlarged with pulmonary vascular ##ity and bilateral layer ##ing pleural effusion ##s with compressive basilar ate ##lec ##ta ##sis .
pred: 3. correct value: 1
comparison to _ _ _ . mild pulmonary edema persists in almost unchanged manner . no pleural effusion ##s . mild cardio ##me ##gal ##y . no evidence of pneumonia .
pred: 3. correct value: 1
1 . interval increase in air ##space opac ##ity in both lungs , right slightly more than the left , consistent with worsening pulmonary edema . overall , cardiac and mediastinal contours are likely stable . no evidence of pneumothorax . probable small layer ##ing right effusion .
pred: 3. correct value: 0
and underlying mediastinal lip ##omatosis , however , in the absence of priors for comparison , lymphadenopathy or other mediastinal process not excluded . no definite focal consolidation .
pred: 1. correct value: 0
lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 2. correct value: 0
1 . no acute cardiopulmonary process . 2 . no evidence of free intraperitoneal air .
pred: 2. correct value: 0
no evidence for active cardiopulmonary disease .
pred: 1. correct value: 0
1 . stable cardio ##me ##gal ##y and mild vascular plethora . 2 . bib ##asi ##la ##r patchy opac ##ities left - greater - than - right . the possibility of an early pneumon ##ic infiltrate cannot be excluded .
pred: 3. correct value: 1
no pneumothorax , after removal of a portion of the still moderate right pleural effusion . lungs are clear . moderate cardio ##me ##gal ##y is long ##standing . trans ##ven ##ous right atrial and right ventricular pace ##r leads are unchanged in standard positions . patient has had mitral valve replacement via median stern ##otomy .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
interval resolution of the previously documented right middle lobe pneumonia . no radiographic evidence for acute cardiopulmonary process .
pred: 1. correct value: 0
pleural effusion ##s . subtle left retro ##car ##di ##ac opac ##ity may relate to edema and pleural effusion ##s , although underlying consolidation from infection cannot be excluded in the appropriate clinical setting . additionally , on the lateral view , more focal opac ##ity projecting over the anterior cardiac sil ##hou ##ette , not well localized on the frontal view , consolidation from infection not excluded .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
definite acute cardiopulmonary process .
pred: 1. correct value: 0
small right effusion is grossly unchanged allowing in the difference in positioning of the patient . right lower lobe ate ##lec ##ta ##sis has increased . there is questionable increase in small left effusion . cardio ##medi ##astin ##al contours are unchanged .
pred: 1. correct value: 0
previous right pleural effusion has nearly resolved following insertion of the basal pleural drainage catheter . no pneumothorax . widespread infiltr ##ative pulmonary abnormality most readily explained by pulmonary edema , however central adeno ##path ##y is suspected . heart size is normal . abnormal increase in radio ##den ##si ##ty to the thoracic spine suggests diffuse oste ##osclerosis such as blast ##ic metastasis or metabolic bone disease . recommendation ( s ) : left jugular central venous infusion catheter ends in the low sv ##c . patient has had right axillary node dissection .
pred: 3. correct value: 2
cough .
pred: 1. correct value: 0
interval enlargement of a left - sided pleural effusion which is now moderate to large in size with adjacent ate ##lec ##ta ##sis .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is noted . the patient is severely rotated . unchanged borderline size of the cardiac sil ##hou ##ette . unchanged elongation of the descending aorta . no pleural effusion ##s . no pneumonia , minimal ate ##lec ##ta ##sis at the left lung bases . no pneumothorax . the right pic ##c line and the nas ##ogastric tube are in unchanged normal position .
pred: 3. correct value: 1
intrath ##oracic metastatic disease .
pred: 1. correct value: 0
yes ##ter ##day .
pred: 1. correct value: 0
no significant interval change from yes ##ter ##day . tubes and lines in adequate position .
pred: 3. correct value: 0
and stable right basilar consolidation , compatible with pneumonia .
pred: 1. correct value: 0
1 . right subcl ##avi ##an pic ##c line , tip near sv ##c / ra junction . 2 . minimal bib ##asi ##la ##r ate ##lec ##ta ##sis . otherwise , no acute pulmonary process identified .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is no evidence of pneumothorax . the curv ##iline ##ar opac ##ification on the left represented a skin fold . otherwise little change .
pred: 3. correct value: 0
comparison to _ _ _ . as compared to the previous radiograph , the patient has received the tracheal stent . lung volumes have decreased . ate ##lec ##ta ##se ##s are seen at both the left and the right lung bases . subsequent new increased radio ##den ##si ##ty at the right lung bases . repeat chest radiograph is recommended to exclude developing pneumonia .
pred: 1. correct value: 0
increased from _ _ _ . in the correct clinical context , superimposed pneumonia should also be considered .
pred: 1. correct value: 0
left lower lobe consolidation is concerning for pneumonia .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no previous images . relatively low lung volumes , but no evidence of with acute pneumonia , vascular congestion , or pleural effusion . there is a well - circums ##cribed area of opac ##ification projected over the sixth posterior rib on the left . this is unchanged from the chest radiograph of _ _ _ at was shown to represent a bone island on the ct of _ _ _ .
pred: 3. correct value: 0
there are no prior chest radiographs available for review . lungs are mildly hyper ##infl ##ated . frontal view shows no focal pulmonary abnormality ; greater than expected radio ##den ##si ##ty projecting over the heart on the lateral view is probably a function of rotation and overlying soft tissue . i would recommend a repeat lateral view , carefully positioned . if the abnormality persists , oblique views should be obtained to determine if there is pneumonia or other pulmonary abnormality not seen on the frontal view . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal . no displaced rib fracture is seen , but if there is focal tenderness in the chest wall , that region should be marked and rib detail views should be obtained .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there has been placement of a do ##bb ##ho ##ff tube , which extends to the distal ant ##rum . the left pig ##tail catheter has been removed and there has been a large re ##accum ##ulation of pleural fluid . otherwise little change .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
6 weeks after antibiotic therapy to document substantial resolution . dr . _ _ _ _ _ _ the findings with dr . _ _ _ by telephone at 1 : 16 ##pm on _ _ _ .
pred: 1. correct value: 0
low lung volumes , no radiographic evidence of pneumonia .
pred: 1. correct value: 0
not visualized . recommend advancing for secure positioning . these findings were discussed with dr . _ _ _ by dr . _ _ _ via telephone on _ _ _ at 1 : 30 p . m . , at time of discovery .
pred: 1. correct value: 0
and the tip of the endotracheal tube projects over the mid thoracic trachea , 4 . 8 cm from the car ##ina . a gastric tube extends into the body of the stomach . low bilateral lung volumes with mild bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . bilateral pleural effusion ##s , of moderate extent and better seen on the lateral than on the frontal radiograph , are unchanged . status post stern ##otomy . moderate cardio ##me ##gal ##y with elongation of the descending aorta but no evidence of pulmonary edema . plate ##li ##ke ate ##lec ##ta ##sis in the left upper lobe . no pneumonia .
pred: 3. correct value: 1
no acute cardiopulmonary process . no pneumothorax .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . the lung volumes are low . moderate tort ##uo ##si ##ty of the thoracic aorta . no pleural effusion ##s . no pneumonia , no pulmonary edema . vertebral fixation devices in the lumbar spine .
pred: 3. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette , replaced valve and stern ##otomy wires are stable in appearance . there is no pleural effusion . there is no pneumothorax . large calcification in the superior aspect of the right kidney is unchanged .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
interval placement of an endotracheal tube whose tip is at the car ##ina and should be withdrawn . nas ##ogastric tube in appropriate position . hope ##fully to visit evolving may extend to the tube had the endotracheal tube had already been withdrawn at time of this dict ##ation as seen on follow up ct .
pred: 3. correct value: 0
luc ##ency under the right hemi ##di ##aph ##ragm still concerning for free air versus chi ##la ##idi ##ti .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
subs ##eg ##mental right basilar ate ##lec ##ta ##sis . otherwise , no acute cardiopulmonary abnormality .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the pace ##r device has been removed . lower lung volumes accent ##uate the transverse diameter of the heart . no evidence of pneumothorax . mild basilar ate ##lec ##ta ##tic changes without definite vascular congestion or acute focal pneumonia .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little interval change . no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
subtle focal patchy opac ##ity projecting over the anterior lower lung on the lateral view , and not well substantia ##ted on the frontal view , could represent a small focus of infection or ate ##lec ##ta ##sis .
pred: 3. correct value: 0
the _ _ _ tube is again seen cours ##ing below the diaphragm with the tip not identified but the balloon remaining inflated at the level of the gastroesophageal junction . the endotracheal tube and right internal jugular central lines are unchanged in position . there continues to be small to moderate layer ##ing effusion ##s , right greater than left , but overall the mild interstitial pulmonary edema has improved . patchy opac ##ities at the lung bases most likely reflect compressive ate ##lec ##ta ##sis . overall cardiac and mediastinal contours are stable . no pneumothorax .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
background interstitial abnormality again seen without definite focal lob ##ar consolidation .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces .
pred: 1. correct value: 0
diffuse abnormality throughout the lungs compatible with patient ' s history of interstitial lung disease . no definite superimposed acute process noting that subtle changes could easily be obscure ##d .
pred: 3. correct value: 0
1 . do ##bh ##off tube tip has been advanced in the interim , just past the gastroesophageal junction . recommend further advancement by approximately 8 - 10 cm to ensure that the tip remains within the stomach lumen . 2 . right lower lobe ate ##lec ##ta ##sis .
pred: 3. correct value: 0
trans subcl ##avi ##an right ventricular pace ##r leads continuous from the left pector ##al generator . there is no pneumothorax pleural effusion or mediastinal wide ##ning . moderate cardio ##me ##gal ##y is stable . pulmonary vasculature is unremarkable . patient has had right mastectomy .
pred: 3. correct value: 1
as above .
pred: 1. correct value: 0
endotracheal tube terminate ##s 6 . 8 cm above the car ##ina . haz ##y opac ##ities in the lungs , potentially combination of ate ##lec ##ta ##sis in this supine patient although infection is possible .
pred: 3. correct value: 0
pulmonary edema has progressed since the prior study . left mid and lower lung consolidation as well as right basal consolidation appear to be progressed . bilateral pleural effusion ##s are moderate , unchanged . there is no appreciable pneumothorax .
pred: 3. correct value: 0
comparison to _ _ _ . no relevant change is noted . the lung volumes are low . left pleural effusion of moderate extent , with subsequent left retro ##car ##di ##ac ate ##lec ##ta ##sis . signs of mild pulmonary edema persists . stable monitoring and support devices , stable mild cardio ##me ##gal ##y .
pred: 3. correct value: 1
large right pleural effusion has begun to re ##accum ##ulate since _ _ _ following removal of the large right thorac ##ostomy tube ; a smaller right pleural drain remains in place . . small left pleural effusion is stable or slightly increased . since the mediastin ##um remains midline , the volume of new pleural fluid is matched by equivalent volume loss in the severely consolidated right lung . it is also possible that the mediastin ##um is fixed in position , since full ##ness in the right lower parat ##ra ##che ##al station suggests adeno ##path ##y .
pred: 3. correct value: 0
as compared to the previous radiograph , the signs indicative of mild interstitial fluid overload are not substantially changed . the lung bases show an increase in interstitial structures , the lateral radiograph shows minimal blunt ##ing of the dorsal aspect of the cost ##oph ##ren ##ic sinuses , likely suggesting minimal pleural effusion ##s . the size of the cardiac sil ##hou ##ette continues to be mildly enlarged . the aorta is tort ##uous . no new parenchymal abnormalities . no pneumonia .
pred: 3. correct value: 1
right effusion , and middle / lower lobe ate ##lec ##ta ##sis are stable . slight decrease in left ate ##lec ##ta ##sis .
pred: 1. correct value: 0
1 . new left basilar ate ##lec ##ta ##sis . 2 . increased size of mediastinal contour adjacent to the aortic arch is likely due to patient positioning .
pred: 1. correct value: 0
pneumothorax . findings were relay ##ed by dr . _ _ _ to dr . _ _ _ by phone at 10 : 55 a . m . on _ _ _ .
pred: 1. correct value: 0
no acute cardiopulmonary process . tort ##uous aorta .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no significant interval change when compared to the prior study . small bilateral pleural effusion ##s .
pred: 2. correct value: 0
in comparison with the study of _ _ _ , there is again substantial enlargement of the cardiac sil ##hou ##ette without evidence of pulmonary vascular congestion . this discordance raise the possibility of cardiomyopathy or pericardial effusion . there is a biv ##entricular pace ##r in place with leads extending to the right atrium , apex of the right ventricle , and coronary sinus system . no evidence of pneumothorax .
pred: 3. correct value: 1
endotracheal tube , intra - aortic balloon pump , and feeding tube are unchanged in position . there has been removal of the sw ##an - gan ##z catheter from an inferior approach . there is a new sw ##an - gan ##z catheter from a superior approach with the distal tip within a distal right pulmonary arterial branch . this could be pulled back 4 - 5 cm for more optimal placement . heart size is within normal limits . there is a left retro ##car ##di ##ac opac ##ity . there are air ##space opac ##ities more confluent within the right base . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 2
as compared to _ _ _ , there are newly appeared plate ##li ##ke areas of ate ##lec ##ta ##sis , both at the left and the right lung basis . no pulmonary edema . no cardio ##me ##gal ##y . no pleural effusion ##s .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no pneum ##oper ##itoneum .
pred: 1. correct value: 0
no acute intrath ##oracic abnormalities identified . no definite fracture identified .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
comparison to _ _ _ . the pre - existing parenchymal opac ##ities at the right lung base have resolved . the monitoring and support devices are in stable correct position . no pleural effusion ##s . no pneumothorax . no pulmonary edema .
pred: 3. correct value: 0
no acute intrath ##oracic abnormalities identified . subtle displaced fractures involving the left seventh and eighth rib ##s of indeterminate chronic ##ity . if there is further concern for rib fractures , a dedicated rib series would be recommended for further evaluation .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
increased interstitial edema . no pneumonia .
pred: 1. correct value: 0
pulmonary vessel eng ##or ##ge ##ment is increased compared to _ _ _ , consistent with volume overload .
pred: 1. correct value: 0
et tube tip is 6 . 6 cm above the car ##inal . ng tube tip is in the stomach . left subcl ##avi ##an line tip is at the level of mid sv ##c . bilateral pleural effusion ##s and bib ##asal consolidation ##s are overall unchanged . the only area that appears to be slightly worse is in the left lower lung where a layer ##ing pleural effusion versus developing consolidation is a possibility , attention to this area on the subsequent studies is required . there is no evidence of pneumothorax
pred: 3. correct value: 0
possible mild pulmonary vascular congestion .
pred: 1. correct value: 0
as compared to the previous radiograph , all monitoring and support devices , with the exception of the right internal jugular vein catheter , have been removed . the lung volumes have decreased of the extubation . there is a small right pleural effusion , combined to a small right basilar ate ##lec ##ta ##sis as well as a plate ##li ##ke ate ##lec ##ta ##sis on the left . no evidence of pneumothorax . no pulmonary edema . the alignment of the stern ##al wires is unchanged .
pred: 3. correct value: 0
low lung volumes with mild bib ##asi ##la ##r ate ##lec ##ta ##sis , but no focal consolidation to suggest pneumonia .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
worsened fluid overload .
pred: 1. correct value: 0
comparison to _ _ _ . the venous access lines on the right have been removed . the feeding tube is in stable position . borderline size of the heart . elongation of the descending aorta . no pleural effusion ##s . no pneumonia , no pulmonary edema . no evidence of free intra - abdominal air .
pred: 3. correct value: 1
severe ate ##lec ##ta ##sis in the left lower lobe , unchanged . moderately severe ate ##lec ##ta ##sis right lower lobe increased since _ _ _ . persistent wide ##ning of the mediastin ##um due to mediastinal venous eng ##or ##ge ##ment . moderate left pleural effusion increased . new left supra ##hi ##la ##r opac ##ification could be asymmetric edema or early pneumonia . moderate cardiac enlargement is chronic . right pic line ends in the region of the superior cav ##oa ##trial junction .
pred: 3. correct value: 1
no relevant change as compared to the previous examination . monitoring and support devices are constant . lung volumes are low with , bilateral , areas of ate ##lec ##ta ##sis at the lung bases . moderate cardio ##me ##gal ##y . mild pulmonary edema . no new parenchymal opac ##ities .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
sil ##hou ##ette . if concern for mediastinal injury , ct . no displaced rib fracture is seen , although if clinical concern for rib fracture is high , suggest dedicated rib series .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has been ext ##ubated . the 2 chest tubes continue to be in unchanged location . on the left , a mill ##imetric pneumothorax might be present . the extent of pleural fluid has not substantially changed since the previous examination , the overall extent is better appreciated on the lateral than on the frontal radiograph . the pleural fluid is limited to the fis ##su ##re air and the dorsal aspect of the cost ##oph ##ren ##ic sinus . minimal basal ate ##lec ##ta ##sis . no cardio ##me ##gal ##y .
pred: 3. correct value: 2
as compared to the previous image , there is no relevant change . the trache ##ostomy tube is in constant position . no pleural effusion ##s . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures . no pneumonia , no pulmonary edema .
pred: 3. correct value: 2
1 . trace left pleural effusion and stable retro ##car ##di ##ac ate ##lec ##ta ##sis . 2 . no free air below the hemi ##di ##aph ##ragm ##s .
pred: 3. correct value: 0
a feeding tube with wire style ##t in place ending in the upper stomach , and a nas ##ogastric tube extending just beyond to the mid stomach .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the patient has taken a better inspiration . there is no evidence of cardio ##me ##gal ##y , vascular congestion , or pleural effusion or acute focal pneumonia .
pred: 1. correct value: 2
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . nodular opac ##ification is again seen the in the right mid zone laterally , which is been present at least since the earlier study of _ _ _ .
pred: 3. correct value: 0
right internal jugular approach central line terminate ##s with tip in lower sv ##c .
pred: 1. correct value: 0
there has been been no change in the chest since _ _ _ consisting of small residual loc ##ulated right pleural effusion , and the fluid filled neo esophagus . mediastin ##um is a normal postoperative appearance . mild vascular congestion persists in the right lung . left lung clear . heart size normal .
pred: 3. correct value: 2
heart size and mediastin ##um are similar to _ _ _ . lung volumes are lower but there is interval resolution of interstitial edema . there is new o left basal opac ##ity potentially representing ate ##lec ##ta ##sis versus infectious process . right central venous line tip terminate ##s at the level of cav ##oa ##trial junction . pacemaker leads terminate in the expected location of right atrium and right ventricle .
pred: 3. correct value: 1
interval placement of a right - sided pig ##tail catheter without significant interval change in the size of a large multil ##oc ##ulated right pleural effusion . right basal opac ##ity is most consistent with some compressive adjacent ate ##lec ##ta ##sis .
pred: 3. correct value: 0
mild pulmonary edema and small bilateral pleural effusion ##s .
pred: 3. correct value: 0
trace bib ##asi ##la ##r ate ##lec ##ta ##sis , otherwise unremarkable .
pred: 1. correct value: 0
in comparison to the recent radiograph of 1 day earlier , bib ##asi ##la ##r ate ##lec ##ta ##sis is slightly improved on the left and is minimally worse on the right . small left pleural effusion has decreased in size . no other relevant changes .
pred: 3. correct value: 0
no acute cardiopulmonary disease including pneumonia . findings were convey ##ed to dr . _ _ _ _ _ _ following review on _ _ _ at approximately 15 : 45 by dr . _ _ _ .
pred: 1. correct value: 0
left pic line ends roughly at the level of the estimated location of the superior cav ##oa ##trial junction . et tube is in standard placement and nas ##ogastric tube passes below the diaphragm and out of view . widespread pulmonary consolidation has improved dramatically since _ _ _ indicating remission of a component of pulmonary edema , but many areas of more focal pulmonary opac ##ification could be infection , and there is at least a hand ##ful of small nodules most easily seen in the right lung at the level of the first , fourth , and fifth intersp ##aces suggesting either metastasis or septic embol ##i . heart size is normal .
pred: 3. correct value: 2
1 . no acute cardiopulmonary process . no definite pneum ##omed ##ias ##tin ##um or pneumonia . 2 . stable mild compression deformity of a mid thoracic vertebral body .
pred: 1. correct value: 0
right - sided pic ##c solid catheter continues to project over the lower lateral right hemi thorax with persistent right base opac ##ity which is not significantly changed compared to the prior study . query loc ##ulated pleural effusion .
pred: 1. correct value: 0
region concerning for consolidation on the chest radiograph _ _ _ , left lower lobe , has coales ##ced to more compact ate ##lec ##ta ##sis . a similar but smaller region has developed at the right base . lungs are otherwise clear and there is no pleural effusion or evidence of central adeno ##path ##y . heart size is normal .
pred: 3. correct value: 2
1 . left lower lobe pneumonia . 2 . cav ##itary lesion in the left apex with apical opac ##ity , question sequelae of old infection / malignancy . consider ct to further assess once the acute symptoms resolve . 3 . hi ##atal hernia .
pred: 3. correct value: 0
no change since the prior outside radiograph .
pred: 1. correct value: 0
1 . lung fields are clear . 2 . a rounded density projecting over the ivc is unchanged from _ _ _ , although increased from _ _ _ . recommendation ( s ) : a none ##mer ##gen ##t chest ct is recommended for further evaluation .
pred: 3. correct value: 0
comparison to _ _ _ . the radiograph is not substantially changed . low lung volumes . monitoring and support devices are in stable correct position . retro ##car ##di ##ac ate ##lec ##ta ##sis with small left pleural effusion persists . borderline size of the cardiac sil ##hou ##ette . mild fluid overload but no overt pulmonary edema .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
right internal jugular central venous catheter with tip in the mid sv ##c
pred: 1. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
biopsy of the left apical lung mass .
pred: 1. correct value: 0
1 . endotracheal tube terminate ##s 4 . 7 cm above the car ##ina . 2 . incidental ##ly noted 2 cm ill - defined opac ##ity in the right mid / lower lung . recommend correlation with prior imaging to determine the chronic ##ity . if none are available , a chest ct is recommended to exclude malignancy , if / when clinically appropriate . recommendation ( s ) : correlation with prior imaging . consider chest ct further evaluation of right lung opac ##ity , if / when clinically appropriate .
pred: 3. correct value: 0
left lower lobe persistently collapsed . right lung grossly clear . pleural effusion small if any . heart size normal . right pic line
pred: 3. correct value: 2
1 . slight interval decrease in size of moderate to large right pleural effusion . probable trace left pleural effusion . 2 . bib ##asi ##la ##r air ##space opac ##ities likely reflect ate ##lec ##ta ##sis though infection cannot be excluded . 3 . mild pulmonary vascular congestion .
pred: 3. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is unchanged as well as the position of tubes and lines . pulmonary edema is present , mild . bilateral pleural effusion ##s are re - demonstrated .
pred: 3. correct value: 0
small right pneumothorax has decreased both in the basal and apical components . right thorac ##ostomy tube unchanged in position ; was anterior on _ _ _ when chest ct was performed . no appreciable right pleural effusion . right basal ate ##lec ##ta ##sis unchanged . subcutaneous emphysema in the chest wall bilaterally an both sides of the neck is not worsening . no left pneumothorax . heart size normal . emphysema is severe .
pred: 3. correct value: 2
as compared to the previous image , the patient has received a left chest tube . most of the pleural effusion has subsequently drain ##ed . no evidence of pneumothorax . mild cardio ##me ##gal ##y and retro ##car ##di ##ac ate ##lec ##ta ##sis persist . no evidence of pneumonia .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
ate ##lec ##ta ##sis than infection . stable abnormal bul ##ging expans ##ile right upper param ##edia ##st ##inal contour , known to reflect a go ##iter .
pred: 3. correct value: 0
mid / upper lung would be a somewhat unusual pattern for asymmetric pulmonary edema and it is thought to be concerning for a multifocal infectious process .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . moderate left pleural effusion and severe left lower lobe ate ##lec ##ta ##sis persist , unchanged . right lung clear . heart size normal . cardiopulmonary support devices in standard placement ##s .
pred: 1. correct value: 2
as compared to the previous radiograph , there is an increasing opac ##ity in the right upper lobe . pneumonia must be suspected . unchanged very low lung volumes with retro ##car ##di ##ac ate ##lec ##ta ##sis as well as moderate enlargement of the vascular structures at the level of the hil ##us . no larger pleural effusion ##s . the monitoring and support devices are constant .
pred: 3. correct value: 0
interval worsening in pulmonary edema , mild to moderate now .
pred: 1. correct value: 0
low lung volumes with probable bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
improved aer ##ation .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the earlier study of this date , the replaced nas ##ogastric tube tip is about at the level of the esophag ##ogastric junction . it should be push ##ed forward about 10 cm to be in more optimal position . otherwise little change .
pred: 3. correct value: 0
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
pneumonia or chf . if there is strong clinical concern for acute pathology , a repeat is recommended with more optimized technique .
pred: 1. correct value: 0
increased opac ##ification of the left lower lung may be due to developing pneumonia , in the correct clinical setting , or a larger left pleural effusion . no larger right pleural effusion .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is no change or evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . the port - a - cath extends to the right atrium .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . multifocal opac ##ifications with layer ##ing effusion ##s and compressive basilar ate ##lec ##ta ##sis again seen .
pred: 3. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ , most recently one _ _ _ . mild pulmonary edema is new . , moderate pleural effusion ##s and severe bib ##asi ##la ##r consolidation have worsened , raising possibility of concurrent pneumonia . no pneumothorax . heart size normal . left subcl ##avi ##an infusion port ends in the right atrium as before . tav ##r noted . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 4 : 20 pm , 1 minutes after discovery of the findings .
pred: 3. correct value: 2
the low lung volumes exagger ##ate cardio ##me ##gal ##y , but this may have worsened since _ _ _ . very large pulmonary arteries suggest pulmonary arterial hypertension . small bilateral pleural effusion ##s and greater pulmonary vascular eng ##or ##ge ##ment are new . a left pic line ends in the mid - to - low sv ##c . no pulmonary edema or pneumonia . severely calcified mitral annulus predispose ##s this patient to mitral regurgitation .
pred: 3. correct value: 1
patient has had median stern ##otomy . moderate - to - severe cardio ##me ##gal ##y is chronic . small - to - moderate bilateral pleural effusion , has been a recurrent problem , slightly larger today than on _ _ _ . opac ##ification in the right lower lobe has been heterogeneous on several previous studies and is concerning for chronic pneumonia , usually due to aspiration . focal indentation of the trachea just above the level of the aortic arch could be due to dilated inn ##om ##inate artery or alternatively sacc ##ular aortic aneurysm . though additional imaging is indicated would depend upon consideration of patient ' s age and condition . catheter crossing the right diaphragmatic region is difficult to trace , could be in the right pleural space posteriorly .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
status post endotracheal intubation . no evidence of acute cardiopulmonary disease .
pred: 3. correct value: 0
az ##yg ##os vein are chronic . no evidence of pulmonary edema or pneumonia pneumonia .
pred: 2. correct value: 1
new right trans ##jug ##ular right ventricular pace ##r lead in standard placement . small to moderate right pleural effusion decreased since _ _ _ following removal of 2 prominent left trans subcl ##avi ##an biv ##entricular pace ##r leads and pector ##al generator . no pneumothorax or mediastinal wide ##ning . persistent left lower lobe consolidation , probably ate ##lec ##ta ##sis . upper lungs grossly clear . no left pleural abnormality . moderate cardio ##me ##gal ##y stable .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . again there is mild tort ##uo ##si ##ty of the aorta .
pred: 3. correct value: 0
mild - to - moderate cardio ##me ##gal ##y has increased , and there is minimal dilatation of pulmonary vasculature but no edema or pleural effusion . projecting over the right fifth anterior rib is possible _ _ _ - mm wide irregular lung lesion . alternatively , this could be sclerosis at the cost ##ochondral junction . i would recommend shallow oblique views for confirmation . dr . _ _ _ was page ##d .
pred: 3. correct value: 1
no relevant change as compared to the previous image , very limited technical quality of the examination . low lung volumes . elevation of the right hemi ##di ##aph ##ragm . moderate cardio ##me ##gal ##y . mild fluid overload . compression ate ##lec ##ta ##sis at the right lung bases . the left lung bases appears minimally in better ventilated than at the previous examination .
pred: 3. correct value: 1
there are no acute cardiopulmonary process .
pred: 1. correct value: 0
small right pleural effusion . low lung volumes with right greater than left basilar opac ##ities potentially ate ##lec ##ta ##sis although infection is not entirely excluded .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . the monitoring and support devices , including the right chest tube , are in correct position . low lung volumes with bilateral areas of ate ##lec ##ta ##sis are constant . no visible pneumothorax . mild fluid overload but no overt pulmonary edema . unchanged size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
lung base ate ##lec ##ta ##sis , minimal to the left , small to the right with small right pleural effusion . ng tube should be push ##ed down 5 cm .
pred: 3. correct value: 0
probable bib ##asi ##la ##r ate ##lec ##ta ##sis . considering clinical concern for infection , repeat frontal radiograph with improved inspiratory level may be helpful to exclude an early infectious basilar pneumonia .
pred: 1. correct value: 0
1 . et tube enters the main stem bronch ##us . 2 . left internal jugular venous catheter likely abut ##s the lateral wall of the sv ##c . notification : impression 1 . was discussed with dr . _ _ _ , _ _ _ d . by _ _ _ , _ _ _ d . on the telephone on _ _ _ at 7 : _ _ _ am , _ _ _ minutes after discovery of the findings .
pred: 1. correct value: 0
1 . persistent small right apical pneumothorax . 2 . extensive subcutaneous emphysema and pneum ##omed ##ias ##tin ##um , similar to prior studies .
pred: 3. correct value: 0
radiographs : a region of dense consolidation at the left lung base could be ate ##lec ##ta ##sis or pneumonia . upper lungs are clear of consolidation . cardio ##me ##gal ##y is mild and pulmonary and mediastinal vasculature mildly eng ##or ##ged , but there is no pulmonary edema or appreciable pleural effusion . heart is mildly enlarged as is the general cal ##iber of the thoracic aorta . stomach is moderately dist ##ended with air and fluid . findings were discussed by the radiology resident on call with dr . _ _ _ at 3 : 45 a . m . , _ _ _ . incidental note is made of a large calcified subc ##arin ##al lymph node .
pred: 3. correct value: 1
as compared to the previous radiograph , a pre - existing ate ##lec ##ta ##sis at the left lung base has substantially improved and is decreased in extent and severity . there is no evidence of new focal parenchymal opac ##ities potentially reflecting pneumonia . borderline size of the cardiac sil ##hou ##ette . no pulmonary edema . no pneumothorax . the position of the nas ##ogastric tube is in correct .
pred: 3. correct value: 1
however cannot be excluded .
pred: 1. correct value: 0
1 . slightly improved pulmonary edema . 2 . bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 0
effusion . most likely pleural densities represent remaining scar formation ##s .
pred: 1. correct value: 0
since the prior study there has been progression of hil ##ar enlargement and peri ##hi ##la ##r edema . left lower lobe opac ##ity appears to be more conspicuous most likely as part of the edema process . et tube tip is 7 cm above the car ##inal . right internal jugular line tip is at the level of superior sv ##c . ng tube tip is not clearly seen on current examination , most likely in the stomach . no pneumothorax .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . moderate cardio ##me ##gal ##y , deviation of the trachea to the right . moderate left predominant pleural effusion ##s , with subsequent areas of ate ##lec ##ta ##sis at the lung bases . no interval appearance of new parenchymal opac ##ities . no pneumothorax .
pred: 3. correct value: 1
pulmonary edema . recommend correlation with chest ct from today .
pred: 1. correct value: 0
1 . appropriately positioned endotracheal tube . 2 . right lower lobe pneumonia .
pred: 3. correct value: 0
findings suggest pneumonia in the left lower lobe .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
persistent moderate bilateral pleural effusion ##s with associated ate ##lec ##ta ##sis . superimposed infection cannot be excluded . coarse interstitial marking ##s may reflect a degree of fluid overload .
pred: 1. correct value: 0
possible slight worsening of opac ##ity at the left lung base . otherwise , i doubt significant interval change . no pneumothorax identified .
pred: 3. correct value: 0
the lung volumes are normal . normal size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
status post right lower lobe fid ##uc ##ial placement with low lung volumes . no pneumothorax .
pred: 1. correct value: 0
left lower lobe opac ##ity with pleural thickening which may represent pleural fluid collection or acute consolidation . recommend oblique views for further visualization .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
ng tube tip is in the stomach . left pic ##c line tip is at the level of cav ##oa ##trial junction . cardio ##me ##gal ##y is substantial . interstitial pulmonary edema has progressed in the interim . left lower lobe consolidation appears to be overall unchanged
pred: 3. correct value: 1
comparison to _ _ _ . stable position of the right internal jugular vein catheter . stable mild cardio ##me ##gal ##y . no pulmonary edema , no pleural effusion ##s . no pneumothorax . no evidence of pneumonia . the chest radiograph shows no signs of rib fractures .
pred: 3. correct value: 1
to the prior study .
pred: 1. correct value: 0
1 . nas ##ogastric tube terminate ##s in the stomach ; decreased gastric dist ##ention following placement . 2 . small right apical pneumothorax and multiple contiguous right - sided rib fractures . 3 . multifocal ate ##lec ##ta ##sis and small pleural effusion ##s . more confluent opac ##ity in right lung base posteriorly could reflect ate ##lec ##ta ##sis , aspiration or infection .
pred: 3. correct value: 0
no comparison . status post tracheal stent placement . the stent appears in correct position . right and left main bronchi also show stenting . no pneumothorax . low lung volumes with mild fluid overload but no overt pulmonary edema .
pred: 3. correct value: 0
right ij catheter terminate ##s at the lower sv ##c .
pred: 1. correct value: 0
tip of the new right internal jugular line projects over the upper to mid sv ##c . no pneumothorax , associated mediastinal wide ##ning or pleural effusion . mild pulmonary edema has improved substantially since earlier in the day . heterogeneous opac ##ification in the axillary region of the left lung is pneumonia until proved otherwise . moderate - to - severe cardio ##me ##gal ##y is chronic . trans ##ven ##ous right ventricular pace ##r lead follows the expected course .
pred: 3. correct value: 1
status post left - sided vat ##s procedure . a left chest tube is in situ . there is no convincing evidence for the presence of the left postpr ##oc ##ed ##ural pneumothorax . on the right , the new esophagus is seen in almost unchanged manner . however , given the lower lung volumes , there are areas of ate ##lec ##ta ##sis at the right lung bases . moderate cardio ##me ##gal ##y . no pulmonary edema . no larger pleural effusion ##s .
pred: 3. correct value: 1
heart is minimally larger , but still normal size . mild interstitial edema is present in the lung bases . there is no focal consolidation . small bilateral pleural effusion is presumed . upper enteric drainage tube passes into the stomach , alongside a percutaneous gastro ##st ##omy tube , and then passes out of view . trache ##ostomy tube in standard position . no pneumothorax . volume of pleural fluid is difficult to assess , at least small , on the left . many vascular clips denote extensive surgery in the right neck .
pred: 3. correct value: 0
1 . endotracheal tube terminate ##s 1 . 1 cm above the car ##ina , withdrawal of at least 3 cm is recommended for appropriate positioning . 2 . left subcl ##avi ##an central venous catheter crosses midline and its tip terminate ##s in the right brach ##io ##cep ##ah ##lic vein , repositioning is recommended . these findings were discussed with _ _ _ by _ _ _ via telephone on _ _ _ at 10 : 48 a . m . , at time of discovery .
pred: 3. correct value: 0
bilateral , multiple rib deformities . new expans ##ile lytic lesion involving the right seventh rib posteriorly concerning for multiple myeloma .
pred: 1. correct value: 0
as compared to previous radiograph of 1 day earlier , a bilateral and asymmetrical ##ly distributed pattern of pulmonary edema has shifted in distribution and overall slightly worsened in severity . no other relevant changes .
pred: 3. correct value: 0
bilateral pleural drain ##s are still in place . there is no appreciable pneumothorax and pleural effusion is small on the right if any . mediastinal cal ##iber is stable since _ _ _ following removal of midline drain ##s . sw ##an - gan ##z catheter tip projects over the main pulmonary artery . trans ##ven ##ous right atrial and ventricular pace ##r leads are in standard placement ##s . the course of the right pic line is obscure ##d by the right pector ##al pacemaker generator . ate ##lec ##ta ##sis is minimal and there is no pulmonary edema .
pred: 3. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . feeding tube ends at the pyl ##or ##us . mild pulmonary edema , small right pleural effusion and chronic moderate to severe cardio ##me ##gal ##y all unchanged . no pneumothorax .
pred: 3. correct value: 1
1 . enteric feeding tube with side port at level of the diaphragm and tip within the stomach . consider advancing 3 - 5 cm for better positioning . 2 . stable chest , with linear ate ##lec ##ta ##sis , scarring , and small left pleural effusion . no evidence of pneumonia . 3 . persistent pneum ##obi ##li ##a , as seen on ct from _ _ _ .
pred: 3. correct value: 0
low lung volumes with bronch ##ovascular congestion and bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 0
small right pleural effusion has decreased over night . residual pulmonary edema is minimal in the right lower lung . severe cardio ##me ##gal ##y is chronic . there is no pneumothorax . multiple epicardial pace ##r leads are unchanged in their positions , has are right trans subcl ##avi ##an pace ##r leads and an a left supra ##cl ##avi ##cu ##la ##r central venous line ends in the low sv ##c . feeding tube passes into the stomach and out of view . no pneumothorax .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
as compared to the previous radiograph , the nas ##ogastric tube and the endotracheal tube are in constant position . the bilateral basal parenchymal opac ##ities , right more than left , are also constant . moderate cardio ##me ##gal ##y persists . mild fluid overload but no overt pulmonary edema . no pneumothorax . clips projecting over the right cervical region .
pred: 3. correct value: 1
1 . the do ##bb ##ho ##ff tube terminate ##s in the stomach . 2 . worsening right ate ##lec ##ta ##sis and pleural effusion .
pred: 3. correct value: 0
there is interval decrease in left pleural effusion . there are multiple nodules projecting over the left lower lung , 1 of them potentially representing nip ##ple but the rest cannot be explained without father assessment with chest ct . small right pleural effusion is demonstrated . no pneumothorax is seen .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there are improved lung volumes . the cardiac sil ##hou ##ette remains at the upper limits of normal in size and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia . some ate ##lec ##ta ##tic changes are seen at the left base . of incidental note is a probable small hi ##atal hernia .
pred: 3. correct value: 1
these findings were discussed with dr . _ _ _ at 2 : 15 p . m . on _ _ _ by telephone .
pred: 1. correct value: 0
chest to further assess as recommended previously .
pred: 1. correct value: 0
compared to prior chest radiographs since _ _ _ , most recently _ _ _ . heterogeneous opac ##ification in the right lower lung , probably anterior and medial basal segments of the right lower lobe , new since _ _ _ is probably pneumonia . patient has had median stern ##otomy and at least coronary bypass grafting . mild cardio ##me ##gal ##y with particular enlargement of the left atrium and pulmonary vascular eng ##or ##ge ##ment are chronic , but there is probably no acute pulmonary edema and no pleural effusion . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ _ _ _ , m . d . on the telephone ##on _ _ _ at 3 : 27 pm , 1 minutes after discovery of the findings .
pred: 3. correct value: 1
left subcl ##avi ##an line tip is at the level of lower sv ##c . cardio ##medi ##astin ##al sil ##hou ##ette is unchanged including cardio ##me ##gal ##y . pulmonary edema has progressed in currently moderate to severe associated with bilateral pleural effusion ##s
pred: 3. correct value: 1
no significant interval change .
pred: 1. correct value: 0
mild vascular congestion . .
pred: 1. correct value: 0
as compared to the previous radiograph , the monitoring and support devices are in unchanged correct position . the lung volumes have minimally decreased . a pre - existing left pleural effusion has minimally increased , with an increasing retro ##car ##di ##ac and left basilar ate ##lec ##ta ##sis . taking into account decreased lung volumes , there is no substantial change in appearance of the right lung . no overt pulmonary edema .
pred: 3. correct value: 0
slightly low lung volumes . no pleural effusion .
pred: 1. correct value: 0
as compared to the previous radiograph , the pre - existing parenchymal opac ##ity on the left has completely resolved . there currently is no evidence of pneumonia , pulmonary edema or pleural effusion ##s . minimal ate ##lec ##ta ##sis at the right lung bases is constant in appearance . the trache ##ostomy tube is also unchanged . no pneumothorax .
pred: 3. correct value: 0
with persistent small bilateral pleural effusion ##s and bib ##asi ##la ##r air ##space opac ##ities likely reflecting ate ##lec ##ta ##sis , but infection is not excluded .
pred: 3. correct value: 0
compared to prior chest radiographs and chest cta , _ _ _ . severe infiltr ##ative pulmonary abnormality , stable on the right , increased slightly on the left , accompanied by increasing moderate cardio ##me ##gal ##y suggests that in addition to interstitial lung disease there is a component of mild edema . left pic line ends in the low sv ##c . pleural effusion is presumed , but not substantial . no pneumothorax .
pred: 3. correct value: 1
1 . no acute cardiopulmonary process . 2 . mild anterior wed ##ging of a upper thoracic vertebral body , similar to slightly progressed since _ _ _ .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices have been removed . again there is substantial enlargement of the cardiac sil ##hou ##ette with only mild elevation in pulmonary venous pressure . this discordance again raises the possibility of cardiomyopathy . mild ate ##lec ##ta ##tic changes persist at the left base .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
conjunction with imaging of the chest on an abdomen ct performed earlier today and reported separately . small bilateral pleural effusion ##s are essentially unchanged . lungs are well expanded and clear . normal cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes . no free subd ##ia ##ph ##ragm ##atic gas . healed right mid rib fracture .
pred: 3. correct value: 0
the nas ##ogastric tube terminate ##s in the distal esophagus . this would need be to be advanced for better positioning in the stomach . notification : the findings were discussed with dr . _ _ _ _ _ _ resident ) by telephone at 14 : 05 on _ _ _ , within _ _ _ min of discovery .
pred: 1. correct value: 0
increased moderate to right - sided pleural effusion .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . again there are low lung volumes with areas of opac ##ification at the bases consistent with layer ##ing effusion ##s and ate ##lec ##ta ##sis . cardiac sil ##hou ##ette is at the upper limits of normal in size or mildly enlarged and there probably is some mild elevation of pulmonary vascular pressure . small left pneumothorax is again suggested . the subcutaneous emphysema along the lateral chest wall has cleared . monitoring and support devices are essentially unchanged .
pred: 3. correct value: 2
no previous images . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
no acute cardiopulmonary radiographic abnormality .
pred: 1. correct value: 0
with either aspiration or infection .
pred: 1. correct value: 0
no previous images . the heart is normal in size and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
disease .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , of the monitoring and support devices are essentially unchanged . the right lung the is clear and there is no evidence of vascular congestion . however , there has been apparent displacement of the heart and mediastinal structures to the left . although there is mild obl ##iqu ##ity of the patient , the possibility of a mucous plug ##ging causing partial collapse of the left lung must be excluded . notification : dr . _ _ _ .
pred: 3. correct value: 1
compared to chest radiographs since _ _ _ , most recently _ _ _ : 06 . extensive bilateral consolidation which developed sudden ##ly between 10 : 30 and 13 : 30 on _ _ _ worsened subsequently and have since improved . findings suggest massive aspiration , with probable conversion 2 pneumonia . there is no evidence currently of volume overload or cardiac decompens ##ation . heart size is normal , but small pleural effusion ##s could be present . there is no pneumothorax . right jugular line ends close to the superior cav ##oa ##trial junction , esophageal drainage tube ends in the mid ##portion of the nond ##ist ##ended stomach and , with the chin flex ##ed , tip of the endotracheal tube 3 cm above the car ##ina is standard . sharp definition of the upper margin of the et ##t cuff indicates secretions pooling above it . clinical attention advised . recommendation ( s ) : tracheal suction .
pred: 3. correct value: 2
status post right port - a - cath placement . correct position of the device . right - sided chest tube in place . moderate right pleural effusion . extensive left pleural effusion , potentially with a larger collapsed left lung portion . extensive cardio ##me ##gal ##y . all findings can be explained by the thorac ##oscopy and the ple ##uro ##des ##is . however , the left hemi ##th ##orax should be checked on short term radiographic followup for the potential presence of a pneumothorax .
pred: 3. correct value: 1
1 . no acute cardiac or pulmonary findings . 2 . marked elevation of the left hemi ##di ##aph ##ragm , not significantly changed compared to ct from _ _ _ .
pred: 1. correct value: 0
moderate pulmonary edema . small right pleural effusion and possible trace left pleural effusion .
pred: 3. correct value: 0
there is no pneumothorax , effusion , dense consolidation or chf . degenerative changes and scoliosis are present in the spine . there is probable osteop ##enia .
pred: 3. correct value: 0
worsening bib ##asi ##la ##r pneumonia or aspiration .
pred: 1. correct value: 0
parenchymal opac ##ity at the left lung base with air bronch ##ograms is consistent with pneumonia . the lateral radiograph shows no pleural effusion ##s . normal size of the cardiac sil ##hou ##ette . no pulmonary edema .
pred: 1. correct value: 2
1 . emphysema with an unchanged moderate - sized left pleural effusion with fluid tracking into the left fis ##su ##re and a left - sided chest tube in unchanged position . 2 . likely mild interstitial edema with unchanged mild cardio ##me ##gal ##y .
pred: 3. correct value: 1
findings suggest pneumonia in the left lower lung , probably in the ling ##ula .
pred: 1. correct value: 0
interval increase in volume of left - sided pleural effusion .
pred: 1. correct value: 0
compared to _ _ _ chest radiograph , cardio ##medi ##astin ##al contours are stable . diffuse heterogeneous opac ##ities persist throughout both lungs . interval worsening of more focal opac ##ities in the right middle lobe and left lower lobe partially obsc ##uring the right heart border and left hemi ##di ##aph ##ragm , respectively , which represent developing infectious pneumonia in the appropriate clinical setting .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormalities no pneumothorax .
pred: 1. correct value: 0
1 . chest tube in appropriate position with in minimal unchanged left apical pneumothorax . 2 . unchanged moderate left pleural effusion .
pred: 3. correct value: 0
heart size is normal . mediastin ##um is normal . rib fractures demonstrated on the left , unchanged , old . lungs are essentially clear . no pleural effusion or pneumothorax is seen . pacemaker leads terminate in the expected location of right atrium and right ventricle .
pred: 3. correct value: 2
the right upper outer mediastin ##um .
pred: 1. correct value: 0
there is persistent but improving bilateral air ##space process suggesting a component of resolving edema . the patient is status post median stern ##otomy . the heart remains markedly enlarged . the feeding tube , right internal jugular central line and right subcl ##avi ##an line are unchanged in position . the single lead left - sided pace ##r is unchanged in position . there is likely a small layer ##ing left effusion when correlated with chest ct _ _ _ . no pneumothorax .
pred: 3. correct value: 1
lung base only seen along the frontal images , not on the other frontal images , most likely a nip ##ple shadow or artifact , similar in appearance as compared to the prior study . similar size . findings can be further assessed with repeat with nip ##ple markers .
pred: 3. correct value: 0
end is excluded on images .
pred: 1. correct value: 0
comparison to _ _ _ . no relevant change . healed right clav ##icular fracture . no other abnormalities at the level of the chest wall . normal size of the cardiac sil ##hou ##ette . minimal elongation of the descending aorta . no larger pleural effusion ##s . no pneumonia . no lymphadenopathy .
pred: 3. correct value: 2
pulmonary edema has improved since earlier in the day . heart size normal , smaller than before . no appreciable left pneumothorax . left basal pleural tube in place . skin folds should not be mist ##aken for pleural surfaces . moderate right pleural effusion is smaller , right basal pleural drain in place . moderate right lower lobe ate ##lec ##ta ##sis unchanged . no right pneumothorax .
pred: 3. correct value: 2
no new infiltrate
pred: 1. correct value: 0
mild pulmonary vascular congestion without overt pulmonary edema .
pred: 1. correct value: 0
in comparison to prior radiograph from earlier the same date , there has not been a relevant change in the appearance of the chest .
pred: 1. correct value: 0
as compared to _ _ _ , cardio ##medi ##astin ##al contours are stable in appearance with heart upper limits of normal in size , diffuse tort ##uous thoracic aorta , and prominent bilateral pericardial fat pads . lungs are clear with no evidence of pneumonia .
pred: 3. correct value: 0
1 . increased right lower hemi ##th ##orax density is likely due to increased pleural thickening . however , a dedicated chest ct is recommended for further evaluation . 2 . cardio ##medi ##astin ##al sil ##hou ##ette is increased in size in comparison to the prior study and may be representative of a pericardial effusion . this can be further assessed with a dedicated chest ct as well .
pred: 3. correct value: 0
no pneumonia .
pred: 1. correct value: 0
1 . resolution of right lower lobe pneumonia . 2 . over ##infl ##ation with additional findings compatible with copd .
pred: 1. correct value: 0
vascular eng ##or ##ge ##ment .
pred: 1. correct value: 0
ate ##lec ##ta ##sis . no convincing evidence of pneumonia .
pred: 1. correct value: 0
interval removal of prior et and enteric tubes .
pred: 1. correct value: 0
pulmonary vascular congestion developed on _ _ _ a accompanied by increasing bib ##asi ##la ##r ate ##lec ##ta ##sis , and has not cleared ; small bilateral pleural effusion ##s are larger . cardio ##me ##gal ##y is severe . lower pole of the right hil ##us is enlarged , could be due enlarged pulmonary artery or lymph nodes .
pred: 3. correct value: 1
1 . new right middle lobe stre ##ak ##y opac ##ity is probably ate ##lec ##ta ##sis . 2 . hypere ##x ##pan ##ded lungs suggestive of emphysema . 3 . sub - centim ##eter nodule is unchanged and may be in the bones or lungs . this could be further evaluated with a non - emergent chest radiograph with shallow oblique views , or if still unre ##ve ##alin ##g , a chest ct . recommendation ( s ) : a non - emergent chest radiograph with shallow oblique views , or if still unre ##ve ##alin ##g , a chest ct , to further evaluate a left lung or osseous lesion .
pred: 3. correct value: 0
stable chronic findings as described . no evidence of the cardio ##genic pulmonary edema .
pred: 1. correct value: 0
dist ##ended proximal esophagus , which may be related to esophageal dysm ##oti ##li ##ty . no evidence of aspiration or infectious pneumonia .
pred: 3. correct value: 0
no definite focal consolidation .
pred: 1. correct value: 0
no significant interval change .
pred: 1. correct value: 0
there has been very little change . the postoperative right lung is slightly better aer ##ated , but still largely consolidated and the persistent right pleural space is large , now filled with more fluid . right basal pleural drain unchanged in position . borderline peri ##hi ##la ##r edema , left lung , unchanged . extent of right ##ward mediastinal shift has not improved . et tube is in standard placement , but nas ##ogastric tube still needs to be advanced at least 15 cm to move all the side port ##s into the stomach , as noted previously .
pred: 3. correct value: 0
left pleural effusion ##s . the left is minimally improved .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
et tube in appropriate position . low lung volumes with bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there is improved aer ##ation at the left base since the prior study . there are no pneum ##otho ##ra ##ces or overt pulmonary edema .
pred: 3. correct value: 0
endotracheal tube has been removed . there is improved aer ##ation at the right upper lobe . however , there is new area of consolidation at the left base which may be due to ate ##lec ##ta ##sis or developing infiltrate . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 0
interval exchange with placement of a dual lumen left internal jugular central line which has its most distal tip in the distal sv ##c . right subcl ##avi ##an pic ##c line unchanged in position . trache ##ostomy tube in satisfactory position . status post median stern ##otomy for cabg with stable postoperative cardiac and mediastinal contours . small layer ##ing bilateral effusion ##s with associated left basilar ate ##lec ##ta ##sis . interval appearance of mild interstitial edema . no pneumothorax .
pred: 3. correct value: 0
lungs are clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes are normal aside for mediastinal fat deposition .
pred: 3. correct value: 0
patchy bib ##asi ##la ##r opac ##ities may reflect ate ##lec ##ta ##sis or consolidation / aspiration in the proper clinical context .
pred: 3. correct value: 0
mild pulmonary vascular eng ##or ##ge ##ment and bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
very subtle opac ##ity seen at the left base on the frontal view appears less conspicuous on the current exam and may reflect an area of persistent or resolving infection in the appropriate clinical setting .
pred: 1. correct value: 0
no acute cardiopulmonary process . no free air is seen below the diaphragm ##s .
pred: 1. correct value: 0
moderate - to - large right pleural effusion is increasing . moderate enlargement of the cardiac sil ##hou ##ette , which worsened from _ _ _ and _ _ _ to _ _ _ is still present and small left pleural effusion has increased , while mild pulmonary edema has remained unchanged . findings could all be due to volume overload and cardiac decompens ##ation , but possibility of ser ##ositis should be enter ##tained because of the disproportion of increasing effusion to pulmonary edema . left subcl ##avi ##an infusion port ends low in the sv ##c . no pneumothorax .
pred: 3. correct value: 1
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . specifically , no evidence of old healed tuberc ##ulous disease . of incidental note are surgical clips in the lower neck .
pred: 3. correct value: 0
1 . following thorac ##ocent ##esis , large right pleural effusion has substantially resolved with residual mild - to - moderate fluid and minimal right lung base and middle lobe ate ##lec ##ta ##sis . 2 . opac ##ity in the right upper lobe is consolidation unless otherwise proven . 3 . 5 . 5 - mm granuloma in the left mid lung
pred: 3. correct value: 0
comparison to _ _ _ . pre - existing signs of pulmonary edema have markedly decreased in severity . the patient now shows mild fluid overload but no overt pulmonary edema . bilateral symmetrical areas of ate ##lec ##ta ##sis are visualized at the left and right lung bases . moderate cardio ##me ##gal ##y . mild elongation of the descending aorta . _ _ _ , md , phd
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
1 . interval development of mild interstitial pulmonary edema and enlargement of still small layer ##ing bilateral pleural effusion ##s . 2 . persistent retro ##car ##di ##ac opac ##ification that could either represent ate ##lec ##ta ##sis though pneumonia is also a possibility in the correct clinical setting .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
moderate left pleural effusion has increased , and there is more consolidation in the left lower lung , which could be ate ##lec ##ta ##sis but raises concern for either infection or local pulmonary hemorrhage . previously questioned abnormal bul ##ging mediastinal contour in region of the pulmonary outflow tract , is less pronounced suggesting it was pleural fluid , which has drain ##ed elsewhere . no pneumothorax . tiny right pleural effusion and pulmonary vascular congestion have nearly resolved . heart size normal .
pred: 3. correct value: 2
top - normal to mild enlargement of the cardiac sil ##hou ##ette . mild interstitial edema .
pred: 2. correct value: 1
no acute intrath ##oracic process . no signs of pneum ##oper ##itoneum .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . increasing right lower lung pulmonary edema . 2 . unchanged positioning of the pulmonary arterial catheter , termin ##ating in the right main pulmonary artery .
pred: 1. correct value: 0
represent interstitial edema versus chronic underlying interstitial lung disease , similar to previous exam .
pred: 2. correct value: 0
moderate cardio ##me ##gal ##y is a stable . pace ##r leads are in standard position . the aorta is very tort ##uous and calcified . there are low lung volumes . opac ##ities throughout the right lung are grossly unchanged , correspond to multifocal pneumonia . minimal retro ##car ##di ##ac opac ##ities are stable . calcification in the left apex is again noted . there are no new lung opac ##ities . no pneumothorax or enlarg ##ing effusion ##s . mitral annulus calcifications are again noted .
pred: 3. correct value: 1
as compared to the previous radiograph , there is an increasing area of consolidation at the level of the left hil ##us , approximately where the endo ##bronchial coils have been placed . the extent of the small left pneumothorax , drain ##ed by a left - sided chest tube , is constant . no evidence of tension . soft tissue collection in the left chest wall are constant . no change in appearance of the normal right lung .
pred: 1. correct value: 0
1 . improved trace bilateral pleural effusion ##s . 2 . stable right middle lobe cavitation ##s and right upper , middle , and lower lobe focal opac ##ities consistent with history of septic embol ##i .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
right 7th rib . further evaluation with shallow oblique chest radiographs is recommended . please request that the images be reviewed by a radiologist before the patient leaves the radiology department . this information was entered in the radiology department ' s online record for notification of critical results on _ _ _ .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
interval decrease in size of small bilateral pleural effusion ##s .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the endotracheal tube has been removed . the right ij catheter again extends into the right atrium . little change in the enlargement of the cardiac sil ##hou ##ette , pulmonary vascular congestion , and bilateral layer ##ing effusion ##s with compressive ate ##lec ##ta ##sis , more prominent on the right .
pred: 3. correct value: 1
the job off tube tip is in the distal stomach / proximal duodenum . bilateral lower lobe infiltrates are slightly less dense on today ' s study left subcl ##avi ##an line tip is in the sv ##c . the film is centered too low to assess the et tube
pred: 3. correct value: 0
in comparison with study of _ _ _ , the right ij catheter is been removed . there are continued low lung volumes that accent ##uate the transverse diameter of the heart . pulmonary vascular ##ity is essentially within normal limits . bib ##asi ##la ##r opac ##ifications , especially on the right , consistent with pleural effusion and underlying compressive ate ##lec ##ta ##sis . the upper lungs are clear .
pred: 3. correct value: 1
there may be some increase in the volume of fluid in the large right apical cavity containing at least one myc ##etom ##a . left apical cavity , though equally large , has a far thinner rim and no obvious contents . severe hil ##ar retraction is an indication of long ##standing scarring . frontal view suggests interval enlargement and greater wall thickening of a complex of sacc ##ular bronchi ##ect ##asis or inflamed bull ##ae in the right middle lobe . left lower lung is clear . there is no pleural effusion . overall , findings suggest increased inflammation in both the middle lobe and the right apical cavity .
pred: 3. correct value: 0
there has been prior median stern ##otomy . the heart remains enlarged , which may reflect cardio ##me ##gal ##y , although pericardial effusion cannot be entirely excluded . there has been interval improvement in aer ##ation . however , there is full ##ness of the peri ##hi ##la ##r vasculature suggesting mild peri ##hi ##la ##r and interstitial edema . no large effusion ##s are seen . no pneumothorax is appreciated . focal patchy opac ##ity in the retro ##car ##di ##ac area could reflect partial lower lobe ate ##lec ##ta ##sis , although aspiration or pneumonia should also be considered . clinical correlation is advised .
pred: 3. correct value: 1
worsened appearance of the right lower lobe . it is unclear if this is volume loss or infectious infiltrate .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
left lung , with opac ##ity / consolidation in the left mid - to - lower lung fields with shift of the mediastin ##um to the left may be due to partial lung collapse , although underlying pulmonary cont ##usion / hemorrhage is may be present . the left chest tube appears to extend to the level of the medial left diaphragm and may enc ##ro ##ach upon the mediastin ##um . left chest wall subcutaneous emphysema .
pred: 3. correct value: 0
post extubation and removal of multiple support lines , including a left thorac ##ostomy tube . no pneumothorax .
pred: 3. correct value: 0
pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
small bilateral effusion ##s . no pulmonary edema
pred: 1. correct value: 0
ap chest compared to _ _ _ at 10 : 23 a . m . : tip of the upper enteric tube is barely visible in the region of the gastroesophageal junction , where it may be loop ##ed retrograde into the distal esophagus . i would recommend advancing the tube at 8 - 10 cm to make sure all the side port ##s are in the stomach . opac ##ification of both lower lobes persists , whether this is ate ##lec ##ta ##sis alone or concurrent pneumonia is radiographic ##ally indeterminate . there is also a contribution of at least small bilateral pleural effusion , no worse now than earlier in the day . previous mild pulmonary edema and vascular congestion have improved since _ _ _ . heart is normal size . et tube and right internal jugular line are in standard placement ##s . no pneumothorax .
pred: 3. correct value: 0
new left ventricular pace ##r lead , standard placement , continuous from the left pector ##al generator . no pneumothorax , pleural effusion or mediastinal wide ##ning . ind ##welling right atrial lead still terminate ##s along the anterior wall of the right atrium , ventricular lead along the anterior wall of the right ventricle just inferior to the outflow tract , unchanged since at least _ _ _ . mild cardio ##me ##gal ##y stable since _ _ _ . no pulmonary edema , vascular eng ##or ##ge ##ment or other suggestion of cardiac decompens ##ation .
pred: 3. correct value: 1
low lung volumes and patient in a somewhat kyph ##otic position the examination is slightly suboptimal . low lung volumes cause vascular crowding although there may be mild pulmonary vascular congestion . right supra ##hi ##la ##r and left infra ##hi ##la ##r opac ##ities may relate to pulmonary vascular congestion although infectious process or aspiration not entirely excluded in the appropriate clinical setting .
pred: 1. correct value: 0
patient has had median stern ##otomy . lungs are clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ette are normal aside from the tort ##uous heavily calcified aorta . there is no pleural abnormality .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
there no prior chest radiographs _ _ _ . severe left lower lobe ate ##lec ##ta ##sis has not improved , moderate left pleural effusion is larger . previous small right pleural effusion has resolved . mild enlargement of the cardiac sil ##hou ##ette is stable . pulmonary vascular congestion improved . no pulmonary edema . no pneumothorax . trans ##ven ##ous right atrial right ventricular pace ##r leads follow their expected courses from the left pector ##al generator , unchanged .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary process . no free intraperitoneal air .
pred: 1. correct value: 0
no previous images . there is mild hypere ##x ##pan ##si ##on of the lungs , raising the possibility of chronic pulmonary disease . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion or pleural effusion . specifically , no evidence of acute focal pneumonia . _ _ _ , md _ _ _ = _ _ _
pred: 3. correct value: 2
possible small right pleural effusion and right basal ate ##lec ##ta ##sis , seen on the lateral view . lungs otherwise clear . heart size normal . ascending thoracic aorta mildly dilated or tort ##uous .
pred: 3. correct value: 2
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
as compared to the previous radiograph , the pacemaker is in unchanged position . unchanged bilateral pleural effusion ##s . moderate cardio ##me ##gal ##y , mild to moderate pulmonary edema and basal areas of ate ##lec ##ta ##sis . no new focal parenchymal opac ##ities .
pred: 3. correct value: 1
as compared to the previous radiograph , there is an increase in extent of the bilateral pleural effusion and a mild increase in severity . of the pre - existing pulmonary edema . moderate cardio ##me ##gal ##y with bilateral areas of ate ##lec ##ta ##sis persist .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
bilateral osseous expans ##ile soft tissue and chest wall lesions in keeping with history of myeloma . no evidence of pneumonia .
pred: 3. correct value: 0
overall little change since the prior study with left - sided pleural effusion possibly slightly increased compared to prior
pred: 3. correct value: 0
low lung volumes with mild bib ##asi ##la ##r subs ##eg ##mental ate ##lec ##ta ##sis .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . the cardiac sil ##hou ##ette remains at the upper limits of normal or mildly enlarged and there again is tort ##uo ##si ##ty of the aorta . no acute pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 1
persistent retro ##car ##di ##ac opac ##ity , but unchanged , so no definite acute process .
pred: 1. correct value: 0
new small bilateral pleural effusion ##s with bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
mild pulmonary edema .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the peripheral opac ##ification in the left lung has cleared and most likely represented a loc ##ulated area of fluid . there is the vag ##ue suggestion of an area of opac ##ification in the right mid zone , so this could well reflect merely superim ##position of bony structures and normal pulmonary vessels . however , in the appropriate clinical setting , a developing consolidation would have to be considered .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little overall change , again there is huge enlargement of the cardiac sil ##hou ##ette without appreciable vascular congestion , a discordance that suggests underlying cardiomyopathy . dual channel pace ##r device remains in place with leads extending to the right atrium and apex of the right ventricle . no acute focal pneumonia .
pred: 3. correct value: 1
normal chest radiograph .
pred: 1. correct value: 0
low lung volumes with minimal patchy left basilar opac ##ity which may reflect ate ##lec ##ta ##sis . infection however is not excluded in the correct clinical setting .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
moderate right pleural effusion which increased from _ _ _ to _ _ _ is unchanged . left lower lobe ate ##lec ##ta ##sis or dependent edema has resolved since _ _ _ . mild - to - moderate cardio ##me ##gal ##y is stable . patient has had right thoracotomy with rib resection and median stern ##otomy , both remote .
pred: 3. correct value: 1
suggest pneumonia .
pred: 1. correct value: 0
moderate right pleural effusion is slightly smaller compared to _ _ _ . right mid lung opac ##ities likely represent ate ##lec ##ta ##sis however pneumonia cannot be ruled out .
pred: 1. correct value: 0
mild pulmonary edema is increased , bilateral pleural effusion ##s , moderate on the right and small on the left , are unchanged and moderate bib ##asi ##la ##r ate ##lec ##ta ##sis is stable since _ _ _ . concurrent pneumonia cannot be excluded in the appropriate setting . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ _ _ _ on the telephone ##on _ _ _ at 4 : 50 pm , 10 minutes after discovery of the findings .
pred: 3. correct value: 0
infection .
pred: 1. correct value: 0
1 . bib ##asi ##la ##r opac ##ities are likely reflective of ate ##lec ##ta ##sis , however aspiration should be considered in the proper clinical context . 2 . small amount of free air under the right hemi ##di ##aph ##ragm . 3 . suspected hi ##atal hernia .
pred: 3. correct value: 0
no edema or focal pneumonia .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
similar appearance of multifocal consolidation ##s with moderate right and small left pleural effusion ##s , similar to the prior exam and better evaluated on the prior ct .
pred: 3. correct value: 0
comparison to _ _ _ . stable appearance of the left pleural effusion . new small right pleural effusion . subsequent areas of basilar ate ##lec ##ta ##sis are proportional to the extent of the effusion ##s .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no relevant change as compared to the previous image . the large left apical lateral pleural opac ##ity is unchanged . unchanged minimal blunt ##ing of the left cost ##oph ##ren ##ic sinus and retro ##car ##di ##ac ate ##lec ##ta ##sis . the overall lung volumes have not changed . unchanged unremarkable alignment of the stern ##al wires , normal position of the right internal jugular vein catheter .
pred: 3. correct value: 0
interval increase in size of the cardiac shadow with associated pulmonary edema suggest either cardiac decompens ##ation or fluid overload . no obvious air ##space consolidation or abscess formation .
pred: 3. correct value: 1
1 . multiple calcified granulomas are seen projecting over the bilateral lungs , the largest measuring 6 mm on the right and 4 mm on the left , better assessed on recent ct chest from _ _ _ . 2 . otherwise , no acute cardiopulmonary process .
pred: 1. correct value: 0
continued right base opac ##ity , slightly improved compared with _ _ _ . this likely represents a combination of collapse and consolidation and a small pleural effusion . no new infiltrate detected and no left - sided effusion . borderline upper zone redistribution . no overt chf .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the patient has taken a better inspiration . no evidence of pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
heart size and mediastin ##um are normal in appearance . right lung is clear . there is left mid and lower lung opac ##ities , that in the absence of the previous studies unclear if represent chronic scar or new left lower lobe infection . no pleural effusion or pneumothorax is seen . when previous studies become available , add ##end ##um will be gla ##dl ##y added .
pred: 3. correct value: 2
1 . lungs appear well inflated without evidence of focal air ##space consolidation to suggest pneumonia . no pleural effusion ##s , pulmonary edema or pneumothorax . cardiac and mediastinal contours are stable .
pred: 3. correct value: 0
bib ##asi ##la ##r , left greater than right , ate ##lec ##ta ##sis .
pred: 3. correct value: 0
in comparison to _ _ _ radiograph , midline drain ##s and chest tubes have been removed , with an apparent tiny left apical pneumothorax . exam is otherwise remarkable for slight improvement in left basilar ate ##lec ##ta ##sis .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 2. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
stable cardio ##me ##gal ##y with new mild pulmonary vascular congestion and small bilateral pleural effusion ##s .
pred: 3. correct value: 1
seen previously in _ _ _ with multifocal pneumonia . these findings are more consistent with multifocal pneumonia , supp ##eri ##mp ##osed pulmonary edema is possible .
pred: 1. correct value: 0
moderate to large right pneumothorax , increased from prior . a right pig ##tail catheter is present . increasing subcutaneous emphysema over the right chest . findings were communicate ##d to and acknowledged by _ _ _ , md at _ _ _ h _ _ _ pm via telephone , _ _ _ minutes after discovery of findings by _ _ _ , md .
pred: 1. correct value: 0
a trache ##ostomy tube is in - situ , with the tip abut ##ting the tracheal wall . lung volumes are very low with significant bilateral lower lobe ate ##lec ##ta ##sis .
pred: 1. correct value: 0
the the vp shunt is projecting over the right hemi thorax . elevated right hemi ##di ##aph ##ragm is present most likely increased in part due to subp ##ul ##mon ##ic effusion and ate ##lec ##ta ##sis . substantial portion of the right lower lung is still collapsed and substantial amount of pleural effusion is still present . no definitive pneumothorax is seen .
pred: 3. correct value: 0
lung base .
pred: 1. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um , and pleural surfaces . no evidence of intrath ##oracic malignancy or infection .
pred: 3. correct value: 0
1 . interval repositioning of the right pic ##c , with tip now projecting at the cav ##oa ##trial junction . no evidence of right - sided pneumothorax . 2 . persistent low lung volumes and bilateral pleural effusion ##s .
pred: 3. correct value: 0
retro ##car ##di ##ac opac ##ity at the left lung base which is nonspecific and may be ate ##lec ##ta ##sis ; however , cannot rule out infectious process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
right - - _ _ _ small pleural effusion is stable .
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ most recently _ _ _ . mild pulmonary edema has improved substantially since _ _ _ . moderate right pleural effusion persists . heart size top - normal . no pneumothorax . right jugular line ends in the low sv ##c .
pred: 3. correct value: 1
in comparison with the earlier study of this date , the tip of the endotracheal tube now measures approximately 6 cm above the car ##ina . nas ##ogastric tube extends well into the stomach . little overall change in the appearance of the heart and lungs .
pred: 3. correct value: 1
not as well appreciated on this study . followup chest ct recommendation from that study remains . no new focal consolidation seen .
pred: 1. correct value: 0
approximately 3 . 2 cm below the car ##ina , which is in the lower sv ##c / cav ##oa ##trial junction .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the trache ##ostomy remains in place . continued opac ##ification at the lower portion of the right hemi ##th ##orax , most likely representing lower lobe collapse though superimposed pneumonia would be difficult to exclude . retro ##car ##di ##ac opac ##ification with poor definition of the hemi ##di ##aph ##ragm again suggests volume loss in the left lower lobe , though residual consolidation can certainly not be excluded on this single frontal view . otherwise , little change .
pred: 3. correct value: 0
no acute radiographic intrath ##oracic pulmonary disease .
pred: 1. correct value: 0
consolidation , significantly progressed compared with _ _ _ . the possibility of an underlying infectious infiltrate cannot be excluded .
pred: 1. correct value: 0
severe bib ##asi ##la ##r consolidation , probably right lower lobe pneumonia and either left lower lobe pneumonia or left lower lobe collapse , unchanged since earlier on _ _ _ , but both increased substantially since _ _ _ . no pneumothorax following removal of the left pleural drainage catheter . small left pleural effusion is likely . heart size is normal . et tube in standard placement . nas ##ogastric drainage tube ends in the upper portion of a nond ##ist ##ended stomach . notification : dr . _ _ _ reported the findings to dr _ _ _ by telephone on _ _ _ at 3 : 04 pm , 1 minutes after discovery of the findings .
pred: 3. correct value: 2
interval placement of an endotracheal tube which projects 1 . 9 cm from the car ##ina . findings were communicate ##d to and acknowledged by _ _ _ at _ _ _ h _ _ _ by _ _ _ , md
pred: 1. correct value: 0
1 . do ##bh ##off tube the tip in the region of the ge junction , unchanged from prior . 2 . persistent bilateral pleural effusion ##s and pulmonary edema , unchanged from prior .
pred: 1. correct value: 0
left lower lobe pneumonia . notification : findings discussed with dr . _ _ _ at 10 : 30 on _ _ _ by dr . _ _ _ .
pred: 1. correct value: 0
as compared to the previous radiograph , the lung volumes have increased , likely reflecting improved ventilation . pre - existing areas of ate ##lec ##ta ##sis and small pleural effusion ##s at the lung bases have completely resolved . a plate ##li ##ke ate ##lec ##ta ##sis remains visible at the left lung base . there is a known rounded peri ##hi ##la ##r opac ##ity on the left that is completely unchanged . normal size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta .
pred: 3. correct value: 2
endotracheal tube terminate ##s approximately 4 . 8 cm above the car ##ina . low lung volumes . stre ##ak ##y right upper lung areas of opac ##ity may be due to underlying aspiration , ate ##lec ##ta ##sis , and / or infection .
pred: 2. correct value: 0
1 . multiple old rib fracture including a healing fracture adjacent to the right 9 ##th rib . 2 . nodule in the right lower lung field that may be due to nip ##ple shadow . recommend attention on follow up .
pred: 1. correct value: 0
no acute cardiopulmonary process . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 5 : 43 pm , 1 minutes after discovery of the findings .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
there is no pneumothorax , pleural effusion or mediastinal wide ##ning suggesting hematoma . there is instead an increase in cal ##iber of heart and mediastinal vessels suggesting volume overload , and a large region of new consolidation in the left lower lobe concerning for pneumonia , particularly due to aspiration .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
compared to prior chest radiographs _ _ _ and _ _ _ : 25 . new left ij line ends in the mid sv ##c . no pneumothorax or significant pleural effusion or mediastinal wide ##ning . diffuse mild to moderate heterogeneous pulmonary abnormality has an interstitial component and the suggestion of alveolar opac ##ities or pleural thickening in the upper chest . the abnormality is new since _ _ _ , but precise chronic ##ity is indeterminate and differential diagnosis is broad . this could be all pulmonary edema , particular if the patient is hypot ##ensive and in trend ##elen ##burg position . it could be diffuse infection , drug reaction or less likely pulmonary hemorrhage . heart is top - normal size , but definitely increased since _ _ _ . et tube and left internal jugular line are in standard placement ##s and an esophageal drainage tube ends in the stomach .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
presence of pneumonia . if the patient has left base symptoms , then followup imaging to exclude a developing early infiltrate at the left base could be considered . however , the right lung is clear .
pred: 1. correct value: 0
no evidence of pneumonia . small to moderate right pleural effusion and trace left pleural effusion with associated ate ##lec ##ta ##sis .
pred: 3. correct value: 0
pulmonary vascular congestion has worsened since _ _ _ . left lower lobe is still collapsed and there is a suggestion of consolidation in the left upper lobe , concerning for pneumonia . there has been no re - accumulation of right pleural effusion , previously very large on _ _ _ , with a right pleural pig ##tail and to right thorac ##ostomy drain ##s in place , 1 in the upper and the other at the base of the right hemi thorax . heart is moderately enlarged , unchanged . et tube is in standard placement , a left trans jugular sw ##an - _ _ _ catheter ends in the main pulmonary artery . right jugular line ends in the upper right atrium . no pneumothorax .
pred: 3. correct value: 0
minimal ate ##lec ##ta ##sis / scarring right cardio ##ph ##ren ##ic angle . no acute pulmonary process identified .
pred: 1. correct value: 0
mild pulmonary vascular congestion without pulmonary edema .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
interval decrease in small , left pleural effusion without acute complications of thorac ##ente ##sis .
pred: 3. correct value: 0
improved pulmonary edema . stable pulmonary vascular congestion and pleural effusion ##s .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
venous catheter appears in appropriate position .
pred: 1. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
lung volumes are very low , previous left lower lobe collapse is slightly improved following extubation . milder right basal ate ##lec ##ta ##sis is stable . there is no longer pulmonary edema . heart is mildly enlarged . no pneumothorax . pleural effusion ##s small if any .
pred: 1. correct value: 0
increased opac ##ity overlying the right middle lobe concerning for pneumonia with an element of ate ##lec ##ta ##sis . these findings were communicate ##d via telephone by dr . _ _ _ to dr . _ _ _ at _ _ _ on _ _ _ .
pred: 1. correct value: 0
endotracheal tube 6 . 5 cm from the car ##ina and can be advanced 3 cm for optimal positioning . dr . _ _ _ was notif ##ied by page at 19 : 45 on _ _ _ .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . again there are low lung volumes with enlargement of the cardiac sil ##hou ##ette and moderate pulmonary vascular congestion . left basilar opac ##ification raises the possibility of pleural effusion and superimposed pneumonia .
pred: 3. correct value: 1
1 . small right apical pneumothorax with no evidence of tension . 2 . post - op hematoma in ru ##l . recommend continued surveillance to document resolution . notification : findings telephone ##d to dr . _ _ _ by dr . _ _ _ on _ _ _ at 10 : 32 ##am , time of discovery .
pred: 1. correct value: 0
perhaps minimal residual congestive change , but no substantial pulmonary edema or evidence of pneumonia .
pred: 1. correct value: 0
resolution of pneumothorax .
pred: 1. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are clear . there is no pleural effusion or pneumothorax .
pred: 3. correct value: 2
right internal jugular line tip is at the level of mid sv ##c . heart size and mediastin ##um are unchanged including cardio ##me ##gal ##y . there is interval improvement in interstitial pulmonary edema since previous study obtained the same the early a . right pleural effusion is moderate , unchanged
pred: 3. correct value: 1
as compared to the previous radiograph , no relevant change is seen . the lung volumes are normal . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures . minimal ate ##lec ##ta ##sis at the left lung bases . no pleural effusion ##s . no pulmonary edema . mild tort ##uo ##si ##ty of the thoracic aorta .
pred: 3. correct value: 2
as compared to the previous radiograph , the patient has developed a bilateral diffuse parenchymal opac ##ities with air bronch ##ograms . the size of the cardiac sil ##hou ##ette is at the upper range of normal but there are no pleural effusion ##s . the findings would be consistent with permeability edema or diffuse pulmonary hemorrhage . no pneumothorax .
pred: 3. correct value: 1
minimal left basilar patchy opac ##ity , likely ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
consolidation .
pred: 1. correct value: 0
a transient pulmonary edema on the _ _ _ and _ _ _ has resolved and not recurr ##ed , though heart remains substantially enlarged . pleural effusion ##s are small if any . the residual opac ##ification at the base of the left lung could be a combination of remaining edema and ate ##lec ##ta ##sis but raises concern for early pneumonia and should be followed closely . et tube and right internal jugular line are in standard placement ##s respectively . the upper enteric drainage tube ends in the upper stomach but should be advanced at least 8 cm to move all the side port ##s beyond the ge junction . no pneumothorax .
pred: 1. correct value: 0
increase in opac ##ity at the right mid to lower lung is nonspecific , could be due to infection and / or aspiration .
pred: 3. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um and pleural surfaces .
pred: 1. correct value: 0
1 . stable mild to moderate cardio ##me ##gal ##y and mild pulmonary edema . 2 . stable lower lobe predominant air ##space and reticular interstitial opac ##ities , possibly reflecting chronic lung disease . no superimposed focal lung consolidation .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the tip of the endotracheal tube remains about 3 . 5 cm above the car ##ina . other monitoring and support devices are unchanged . the left hemi ##di ##aph ##ragm is better seen , which could reflect either some improvement in pleural fluid and ate ##lec ##ta ##sis or merely a more upright position of the patient . otherwise little change .
pred: 3. correct value: 0
interval resolution of bib ##asi ##la ##r ate ##lec ##ta ##sis with no nodules or consolidation seen .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . hypere ##x ##pan ##si ##on of the lungs suggests some underlying chronic pulmonary disease . however , no acute pneumonia , vascular congestion , or pleural effusion . specifically , no hil ##ar or mediastinal adeno ##path ##y or promin ##ence of interstitial marking ##s to radiographic ##ally suggest sarcoidosis in the chest .
pred: 3. correct value: 0
new right - sided pig ##tail drainage catheter with only trace right pleural effusion remaining , though residual subp ##ul ##mon ##ic effusion cannot be excluded .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
small bilateral pleural effusion ##s increased since _ _ _ . pulmonary hil ##a are chronically enlarged . mediastinal cal ##iber has decreased since _ _ _ when the chest ct showed mediastinal adeno ##path ##y in the prev ##ascular station . very mild interstitial pulmonary abnormality could be early edema . if symptoms persist after cardio ##version , i would recommend chest ct scanning to look for interstitial lung disease .
pred: 3. correct value: 0
ate ##lec ##ta ##sis of the right middle and lower lobes , raising concern for bronchial obstruction . the above findings were communicate ##d to dr . _ _ _ by dr . _ _ _ _ _ _ telephone at 4 : 55 ##pm , _ _ _ min after discovery .
pred: 1. correct value: 0
the do ##bb ##ho ##ff tube extends at least to the mid portion of the stomach were crosses the lower margin of the image . there are low lung volumes with bib ##asi ##la ##r ate ##lec ##ta ##tic changes and small pleural effusion ##s . cardiac sil ##hou ##ette is prominent and there is mild elevation of pulmonary venous pressure . retro ##car ##di ##ac opac ##ification is consistent with some loss of volume in the left lower lobe . there is a right pic ##c line in place . the tip is difficult to see , though it probably is in the mid portion of the sv ##c .
pred: 3. correct value: 1
minimal bib ##asi ##la ##r ate ##lec ##ta ##sis . otherwise , no acute pulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
bib ##asi ##la ##r patchy opac ##ities likely ate ##lec ##ta ##sis .
pred: 1. correct value: 0
in comparison with the earlier study of this date , the tip of the nas ##ogastric tube is in the upper esophagus , though the side port is still in the lower thoracic esophagus . otherwise little change . notification : dr / _ _ _
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there has been some improvement in aer ##ation in the left hemi ##th ##orax . again , the appearance most likely reflects a combination of pleural fluid and underlying compressive ate ##lec ##ta ##sis in a patient with substantial pulmonary vascular congestion and low lung volumes . no evidence of pneumothorax .
pred: 3. correct value: 0
in comparison with the earlier study of this date , there are again low lung volumes with increasing bilateral pulmonary opac ##ifications especially centrally . this could represent flash pulmonary edema , though there is no evidence of enlargement of the cardiac sil ##hou ##ette . therefore , widespread aspiration would have to be considered . endotracheal tube is now in place with its tip approximately 3 cm above the car ##ina . nas ##ogastric tube extends to the distal stomach . the right ij sw ##an - gan ##z catheter again extends to the upper right atrium .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . no displaced fractures are visualized . if there is continued concern for rib fracture , consider a dedicated rib series .
pred: 1. correct value: 0
bib ##asi ##la ##r opac ##ities are again seen . there is a new area of consolidation within the left mid lung field . findings are wor ##ris ##ome for pneumonia or aspiration . heart size is upper limits of normal but unchanged . there are no pneum ##otho ##ra ##ces .
pred: 3. correct value: 1
large left pleural effusion and worsening left lung ate ##lec ##ta ##sis combine to opac ##ify nearly all of the left hemi ##th ##orax , with less aer ##ation now than on _ _ _ . it is difficult to say whether there is more pleural fluid , since the mediastin ##um does not appear to have been shifted more into the right hemi ##th ##orax despite worsening right lower lobe ate ##lec ##ta ##sis , accompanied by increase in a small - to - moderate right pleural effusion . heart size of course is indeterminate . no pneumothorax . careful followup is advised .
pred: 3. correct value: 1
as compared to the previous radiograph , the monitoring and support devices are in correct position . the tip of the endotracheal tube continues to project 3 cm above the car ##inal . the tip of the nas ##ogastric tube is coiled but still safely positioned within the stomach . low lung volumes . moderate cardiac the persists . minimal blunt ##ing of the left cost ##oph ##ren ##ic sinus , potentially reflecting a small pleural effusion . retro ##car ##di ##ac ate ##lec ##ta ##sis . no pneumonia , no overt pulmonary edema .
pred: 3. correct value: 0
mild interstitial pulmonary abnormality is more severe in the right lung at the bases , new since _ _ _ , most likely mild pulmonary edema . the greater opac ##ity in the right lung centrally corresponds to the biopsy target for trans ##bronchial biopsy earlier today and may indicate local hemorrhage . there is no pneumothorax or pleural effusion . heart size is normal .
pred: 3. correct value: 2
1 . findings of the retro ##st ##er ##nal air on lateral projection is unchanged compared to ct _ _ _ , accounting for differences in technique . 2 . unchanged bilateral mid to upper lung opac ##ities and prominent interstitial marking ##s .
pred: 3. correct value: 0
1 . no radiologic evidence for acute cardiopulmonary process . 2 . 2 . 3 x 2 . 2 cm rounded opac ##ity overlying the right upper lobe . this may represent either a pulmonary nodule or potentially a calcification of the cost ##ochondral junction . findings were convey ##ed by dr . _ _ _ to dr . _ _ _ _ _ _ telephone at 4 : 15 ##pm _ _ _ _ _ _ , _ _ _ min after discovery . following discussion with dr . _ _ _ , _ _ _ team has decided to pursue a ct tors ##o examination today to further evaluate this lesion .
pred: 3. correct value: 0
in comparison with the study _ _ _ _ _ _ , the right ij catheter is been removed . the hemi ##di ##aph ##ragm ##s are more sharply seen and the haz ##y opac ##ification at the bases is no longer present . although this may reflect some improvement in pleural effusion ##s and ate ##lec ##ta ##tic changes , much of the difference in appearance may be a manifestation of the erec ##t position of the patient . mild elevation of the left hemi ##di ##aph ##ragm is seen with ate ##lec ##ta ##tic changes at the base . no evidence of acute pneumonia or vascular congestion .
pred: 3. correct value: 0
as compared to the previous radiograph , the patient has developed a right upper lobe pneumonia . large hi ##atal hernia . low lung volumes . moderate cardio ##me ##gal ##y without pulmonary edema . at the time of dict ##ation and observation , 09 : 55 , on the _ _ _ , the referring physician _ _ _ . _ _ _ was page ##d for notification .
pred: 3. correct value: 1
compared to chest radiographs since _ _ _ , most recently _ _ _ . combination of bib ##asi ##la ##r ate ##lec ##ta ##sis and possible small pleural effusion ##s not appreci ##ably changed since _ _ _ . small region of pneumonia could be present at the lung bases , but there is no evidence of pneumonia in the upper lobes low lung volumes exagger ##ate pulmonary vasculature eng ##or ##ge ##ment . heart size is normal . no pneumothorax .
pred: 3. correct value: 2
no relevant change as compared to the previous image . no pneumonia , no pulmonary edema . constant appearance of the monitoring and support devices . moderate cardio ##me ##gal ##y with elongation of the descending aorta .
pred: 3. correct value: 1
subtle nodular opac ##ities in the left upper lobe persist in is patient concerning for an early infectious process . stable cardio ##me ##gal ##y without overt pulmonary edema . low lung volumes with bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 1
1 . low lung volumes with bib ##asi ##la ##r ate ##lec ##ta ##sis . no focal consolidation . 2 . mild pulmonary edema . 3 . severe compression deformity of the t1 ##2 vertebral body of unknown chronic ##ity . correlate with focal tenderness . 4 . apparent inferior subl ##ux ##ation of the right humeral head with respect to the gle ##noid , but this may be projection ##al . correlate with history of shoulder pain / trauma .
pred: 3. correct value: 0
moderate to severe cardio ##me ##gal ##y is stable . sw ##an - gan ##z catheter tip is in the main pulmonary artery . mild vascular congestion has almost completely resolved . bilateral pleural effusion ##s have decrease , the are small associated with minimal adjacent ate ##lec ##ta ##sis . there is no evident pneumothorax . wide ##ning mediastin ##um is stable . stern ##al wires are intact
pred: 3. correct value: 1
hyper ##infl ##ated lungs .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
cardio ##me ##gal ##y is substantial . large hi ##atal hernia is unchanged . there is no interval increase in pleural effusion or development of pneumothorax . previously seen small to moderate amount of left pleural effusion is unchanged . aortic valve is in expected position .
pred: 3. correct value: 1
feeding tube tip is in the distal third of the esophagus .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette is more prominent and there is again evidence mild elevation of pulmonary venous pressure . hypere ##x ##pan ##si ##on of the lungs is consistent with chronic pulmonary disease , though no definite acute focal pneumonia is appreciated . promin ##ence of the central pulmonary vessels suggests pulmonary arterial hypertension . there is soft tissue promin ##ence of the right peri ##tra ##che ##al region . this could merely represent tort ##uous brach ##io ##cephal ##ic vessels , with the apparent increase related to a more oblique position of the patient .
pred: 3. correct value: 1
in comparison to _ _ _ chest radiograph , a right - sided chest tube remains in place , with the tip at the level of the third right posterior rib . a persistent tiny right apical pneumothorax is present , as well as persistent subcutaneous emphysema in the right chest wall . exam is otherwise remarkable for asymmetrical vascular eng ##or ##ge ##ment and peri ##hi ##la ##r haz ##iness on the right , potentially representing asymmetrical pulmonary edema although other superimposed peri ##hi ##la ##r process such as aspiration or developing infectious pneumonia should be considered in the appropriate clinical setting .
pred: 3. correct value: 0
temporary pacing lead terminate ##s in right ventricle , with no evidence of pneumothorax . pulmonary vascular congestion .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with study of _ _ _ , there are lower lung volumes . again there are moderate bilateral pleural effusion ##s with compressive ate ##lec ##ta ##sis at the bases . continued elevation of pulmonary venous pressure , though less prominent than on the previous study . pace ##r device is unchanged . in the appropriate clinical setting , it would be difficult to unequiv ##ocally exclude superimposed pneumonia .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no focal consolidation identified . minimal left basilar ate ##lec ##ta ##sis . prominent upper mediastin ##um , which when compared to the ct scan of the neck date ##d _ _ _ likely represents abundant adipose tissue .
pred: 3. correct value: 0
comparison to _ _ _ , 20 : 36 . no relevant change is noted . the monitoring and support devices , including the right chest tube and the endotracheal tube are in stable correct position . moderate cardio ##me ##gal ##y persists . no pneumothorax . unchanged right pleural effusion and left retro ##car ##di ##ac ate ##lec ##ta ##sis p
pred: 3. correct value: 1
patchy lower lung opac ##ities , nonspecific and probably compatible with ate ##lec ##ta ##sis . in the appropriate clinical setting , however , aspiration or pneumonia could be given consideration .
pred: 1. correct value: 0
endotracheal tube in appropriate position . enteric tube courses below the diaphragm , inferior aspect not included on the image . mild to moderate pulmonary edema . patchy right base opac ##ity could be due to combination of pulmonary edema in ate ##lec ##ta ##sis however , aspiration or infection are also in the differential diagnosis .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there are improved lung volumes . however , there is again opac ##ification at the right base consistent with right lower lobe collapse and pleural fluid . otherwise little change .
pred: 1. correct value: 0
bilateral pleural effusion ##s , small , right greater than left with ill - defined opac ##ity in the right lower lung most consistent with scarring though difficult to exclude pneumonia . large ble ##b in the right upper lung .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest x - ray .
pred: 1. correct value: 0
no acute intrath ##oracic process left ij central venous catheter positioned appropriately .
pred: 1. correct value: 0
mild pulmonary edema has improved since _ _ _ . there is no appreciable ate ##lec ##ta ##sis . mediastinal vascular wide ##ning due in part to supine positioning may have worsened . right pic line ends low in the sv ##c . no pneumothorax .
pred: 3. correct value: 0
radiographs : mild peri ##bronchial opac ##ification at the left lung base posteriorly suggests bronchi ##ect ##asis . lungs are otherwise clear . there is no consolidation or any focal abnormality to suggest infarction , though the diagnosis of acute pulmonary embol ##us is not generally made with conventional chest radiographs . heart size is normal . pulmonary vasculature unremarkable . no pneumothorax or appreciable pleural effusion .
pred: 3. correct value: 2
1 . endotracheal tube in standard position . 2 . enteric tube side port is proximal to the gastroesophageal junction and should be advanced by at least 5 cm for optimal positioning . 3 . bilateral ill - defined peri ##hi ##la ##r opac ##ities , more pronounced on the right , likely reflective of moderate asymmetric pulmonary edema . pneumonia or aspiration , particularly in the right lung , however is not completely excluded . follow up radiographs after di ##uresis are recommended .
pred: 3. correct value: 0
1 . mild central venous eng ##or ##ge ##ment suggestive of hyperv ##olem ##ia . 2 . no evidence of decompens ##ated congestive heart failure or pneumonia .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there are artifacts overlying the left base . nevertheless , the hemi ##di ##aph ##ragm is not seen and there is increased retro ##car ##di ##ac opac ##ification , concerning for pleural fluid and volume loss in the left lower lobe . in the appropriate clinical setting , it would be impossible to exclude superimposed pneumonia , especially in the absence of a lateral view . the remainder of the lungs is clear and there is no evidence of vascular congestion . central catheter remains in place .
pred: 3. correct value: 0
mild increase in subcutaneous emphysema to the contralateral side in the neck as well as pneum ##omed ##ias ##tin ##um . left chest tube is in place . difficult to assess presence of a pneumothorax , chest ct would be the best next imaging modality for further evaluation . notification : the findings were discussed with _ _ _ _ _ _ , m . d . by _ _ _ _ _ _ , m . d . on the telephone on _ _ _ at 2 : 51 ##pm , 10 minutes after discovery of the findings .
pred: 1. correct value: 0
heart size is normal . mediastin ##um is normal . surgical clips a projecting over the mediastin ##um , located patient ' s back . the pic ##c line tip is at the level of mid sv ##c . lungs are clear with interval improvement of the basal variation with only 1 focal linear ate ##lec ##ta ##sis at the right lung base present . no appreciable pleural effusion or pneumothorax is seen .
pred: 3. correct value: 2
as compared to the previous radiograph , the lung volumes remain low . the pre - existing parenchymal opac ##ity and consolidation in the retro ##car ##di ##ac lung regions . with air bronch ##ograms , is not substantially changed . the opac ##ity might reflect ate ##lec ##ta ##sis , pneumonia or a combination of both . no new parenchymal opac ##ities . unchanged moderate cardio ##me ##gal ##y without pulmonary edema . no larger pleural effusion ##s .
pred: 3. correct value: 1
within a bib ##asi ##la ##r and peri ##hi ##la ##r distribution , which could reflect worsening chronic interstitial lung disease . a superimposed infectious process cannot be completely excluded .
pred: 1. correct value: 0
interval advancement of do ##bh ##off tube , beyond ge junction . otherwise , no significant change .
pred: 1. correct value: 0
tip of the left pic line ends in the low sv ##c . enteric feeding tube ends in the upper stomach . moderate bilateral pleural effusion ##s unchanged . pulmonary vasculature is mildly eng ##or ##ged , but unchanged and there is no mediastinal venous dist ##ention . heart size top normal . no pneumothorax .
pred: 3. correct value: 2
right upper lobe and suspected ling ##ular regions of consolidation wor ##ris ##ome for pneumonia given history . recommendations : recommend repeat after treatment to document resolution .
pred: 3. correct value: 0
no acute cardiopulmonary process . stable enlargement of the cardiac sil ##hou ##ette .
pred: 2. correct value: 1
enlargement of the cardiac sil ##hou ##ette is likely accent ##uated by lower lung volumes . no consolidation wor ##ris ##ome for pneumonia .
pred: 2. correct value: 1
right . mildly prominent vascular ##ity suggesting slight congestion . ate ##lec ##ta ##sis or potentially pneumonia could be considered in the appropriate clinical setting regarding focal left lower lobe opac ##ification .
pred: 1. correct value: 0
heart size is normal . mediastinal contours stable in except for increased promin ##ence of the ascending aorta potentially reflecting ascending aortic dilatation . lungs are clear . no pleural effusion or pneumothorax is seen . correlation with ct chest for pre size assessment of the diameter of the ascending aorta is to be considered alternatively mri of the chest .
pred: 3. correct value: 2
increased volume loss at the left lung base . increased right - sided pleural effusion .
pred: 3. correct value: 0
no significant interval change since the radiograph performed 2 hours prior .
pred: 1. correct value: 0
left - sided chest tube terminate ##s over the left hemi thorax . moderate left - sided pleural effusion with adjacent compressive ate ##lec ##ta ##sis of the left lung .
pred: 1. correct value: 0
right hemi ##th ##orax is entirely opac ##ified and mediastin ##um is left ##ward shifted , suggesting a very large , and probably not chronic right pleural effusion . left lung is essentially clear . findings were discussed by telephone with the house office ##r caring for this patient at 10 : 45 a . m .
pred: 1. correct value: 0
large hi ##atal hernia with likely adjacent ate ##lec ##ta ##sis . otherwise , no acute cardiopulmonary process .
pred: 3. correct value: 0
please note that opportunistic infections may be radiographic ##ally occult , and if clinical suspicion is high , chest ct may be considered for further evaluation .
pred: 1. correct value: 0
opac ##ification within the right mid and lower lung fields likely reflects a combination of a moderate pleural effusion and right basilar ate ##lec ##ta ##sis , though infection or aspiration cannot be excluded .
pred: 1. correct value: 0
multi focal pneumonia , left mid ##lu ##ng and right upper lobe unchanged , since earlier in the day , accompanied by greater irregular opac ##ification in both lower lobes suggesting this may be pneumonia as well . the overall picture favors massive aspiration between _ _ _ and _ _ _ when the consolidation first appeared . heart is normal size . pleural effusion minimal if any . new endotracheal tube in standard placement . feeding tube ends in the stomach . no pneumothorax .
pred: 1. correct value: 0
pneumothorax . both lungs are clear .
pred: 1. correct value: 0
represent pneumonia or ate ##lec ##ta ##sis . minimal right pleural effusion , if any . the previously seen nodule in the right lung is not well seen on today ' s study .
pred: 1. correct value: 0
no findings to suggest free air beneath the diaphragm ##s .
pred: 1. correct value: 0
previous mild pulmonary edema has improved . heart is still moderately enlarged and the hil ##ar and other central pulmonary vasculature is still eng ##or ##ged . previous pleural effusion ##s have essentially resolved . there is the suggestion of bronchi ##ect ##asis in the right mid and lower lung zones , which is best evaluated with ct scanning . there is no consolidation or evidence of central lymph node enlargement .
pred: 3. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ : 44 . better position chest radiograph shows moderate left and small right pleural effusion , stable or slightly decreased since _ _ _ , as well as the large subp ##le ##ural mass or abscess in the left mid ##lu ##ng . heart size normal . no pneumothorax . et tube in standard placement . sharp definition of the upper aspect of the tube cuff reflects secretions pooling above it . left pic line ends in the mid sv ##c . esophageal drainage tube passes into the stomach and out of view .
pred: 3. correct value: 2
lungs clear . heart size normal . mediastinal and hil ##ar sil ##hou ##ettes and pleural surfaces unremarkable .
pred: 3. correct value: 2
the nas ##ogastric tube needs to be advanced approximately 4 cm . stable appearance of the lungs , with multiple pulmonary nodules , left retro ##car ##di ##ac opac ##ity and small left pleural effusion .
pred: 3. correct value: 0
no change in the position of the right port - a - cath . possible adjacent soft tissue abnormalities cannot be evaluated with conventional chest x - ray . ultrasound or chest ct is recommended if clinical concern persists . notification : the impression above was entered by dr . _ _ _ on _ _ _ at 17 : 23 into the department of radiology critical communications system for direct communication to the referring provider .
pred: 3. correct value: 0
lungs are well expanded and clear . aside from tort ##uous descending thoracic aorta the cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 3. correct value: 0
trans ##su ##bc ##la ##vian atrial , right ventricular pace ##r defibrill ##ator leads follow their expected courses from the left axillary pacemaker . previous very asymmetric pulmonary edema has substantially cleared , except for a region of consolidation in the right mid lung . small left pleural effusion stable . no pneumothorax . heart size top normal .
pred: 3. correct value: 2
1 . oro ##ga ##st ##ric tube with distal tip pointing superior ##ly near the gastroesophageal junction . repositioning so tip points inferior ##ly is recommended with confirmation of tube course with abdominal radiograph . 2 . right internal jugular central venous catheter appears kink ##ed near the entrance into the skin which may be due to projection or kink ##ing of the catheter . recommendation ( s ) : oro ##ga ##st ##ric tube with distal tip pointing superior ##ly near the gastroesophageal junction . repositioning so tip points inferior ##ly is recommended with confirmation of tube course with abdominal radiograph .
pred: 3. correct value: 0
et tube tip is obscure ##d but could be as high as 7 . 5 cm from the car ##ina . repeat exam is suggested for re - evaluation . ng tube should be advanced as the last side port is above the ge junction . no acute cardiopulmonary process on this limited evaluation .
pred: 3. correct value: 0
as compared to the previous radiograph , there is a minimal increase in severity of the pre - existing pulmonary edema . the lung volumes remain low . areas of ate ##lec ##ta ##sis that pre existed on the prior image , have completely resolved . minimal cardio ##me ##gal ##y . no pleural effusion ##s .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary process . notification : an attempt was made to call the referring provider as _ _ _ wet read was requested , however she could not be reached .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
severe consolidation persists in the right lower lobe . decrease in volume in the lower lobe is probably responsible for its change in appearance rather than necessarily improvement in the extent of lower lobe pneumonia or pulmonary hemorrhage . very small right apical pneumothorax is unchanged . right pleural drain is conceiv ##ably fis ##su ##ral . right upper lobe is clear . heart size is normal . mild peri ##bronchial opac ##ification in the left lower lung is consistent with another focus of pneumonia , particularly aspiration . left basal pleural drain ##s still in position . very small left basal pneumothorax persists . there is no pleural effusion . trache ##ostomy tube and a right subcl ##avi ##an line end in standard positions , and a feeding tube passes into the stomach and out of view . drainage tube ends in the mid stomach . no pneumothorax .
pred: 3. correct value: 2
no evidence of a pneumothorax .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no focal consolidation to suggest pneumonia . re - demonstrated colonic gaseous distension with elevation of the left hemi ##di ##aph ##ragm and overlying left basilar ate ##lec ##ta ##sis .
pred: 1. correct value: 0
hyper ##infl ##ated clear lungs .
pred: 1. correct value: 0
previous small region of pneumonia , probably right middle lobe , seen best on the prior lateral view has resolved . lungs are clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the patient has taken a better inspiration . there are bilateral pulmonary opac ##ifications consistent with alveolar and interstitial opac ##ities , that could well represent asymmetric pulmonary edema . however , this appears low much less prominent today on the left , raising the possibility of superimposed pneumonia on the right . on the lateral views , there does not appear to be substantial pleural effusion .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
no acute cardiopulmonary process . anter ##olateral left rib fractures are noted but are age indeterminate based on these views . consider dedicated rib series .
pred: 2. correct value: 0
1 . et ##t not visualized . 2 . significant interval decrease in the left lung opac ##ity and ate ##lec ##ta ##sis .
pred: 1. correct value: 0
as compared to the previous image , the patient now carries a nas ##ogastric tube . the tip of the tube projects over the proximal parts of the stomach . vascular right - sided stent is again visualized . minimal scarring at the right lung bases . in the right upper lobe , however , there is a virtually unchanged parenchymal opac ##ity that is relatively widespread and shows air bronch ##ograms . in the appropriate clinical setting , pneumonia is the most likely differential diagnosis . because of the long ##standing duration of the changes , further workup with ct should be considered , to evaluate reason for the chronic ##ity of the changes .
pred: 3. correct value: 0
mildly enlarged globular heart , distinctly abnormal for _ _ _ - year - old . recommend cardiac echo . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 8 : 54 am , 5 minutes after discovery of the findings at the time of interpretation of the chest x - ray .
pred: 3. correct value: 0
as compared to the previous radiograph , the monitoring and support devices , including the endotracheal tube and the right internal jugular vein catheter are in unchanged position . there is a minimal increase in extent of a pre - existing left pleural effusion and the subsequent retro ##car ##di ##ac ate ##lec ##ta ##sis . the appearance of the lung parenchyma is otherwise constant . no new focal parenchymal opac ##ities . no pneumothorax .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , allowing for mild differences in degree of rotation there is little overall change . again there is radiation fibrosis in the peri ##hi ##la ##r region of the left lung but no definite evidence of recurrence of intrath ##oracic malignancy . the tip of the pic ##c line extends to the lower sv ##c .
pred: 3. correct value: 0
stable chest radiograph . no new focal lung consolidation .
pred: 1. correct value: 0
1 . moderate - to - large right pleural effusion , likely not significantly changed allowing for differences in technique . 2 . bib ##asi ##la ##r ate ##lec ##ta ##sis , right greater than left . 3 . mild - to - moderate cardio ##me ##gal ##y , not significantly changed .
pred: 3. correct value: 1
feeding tube is been exchanged for a nas ##ogastric tube , which courses below the diaphragm to terminate in the proximal stomach . side port is proximal to ge junction level and the tube could be advanced several cm for standard positioning . bilateral partially loc ##ulated pleural effusion ##s have slightly increased in size in the interval and multifocal air ##space opac ##ities are also slightly worse . dist ##ended loops of bowel in the upper abdomen are incompletely evaluated on this chest radiograph .
pred: 3. correct value: 0
there is a new et tube with tip 5 cm above the car ##ina . lung volumes are low with compressive changes at the bases . an early infiltrate particularly on the right cannot be excluded .
pred: 1. correct value: 0
since a recent radiograph of 1 day earlier , an oro ##ga ##st ##ric tube is been placed , termin ##ating in the body of the stomach . large left pleural effusion has substantially increased in size since ct of _ _ _ , and is associated with adjacent ate ##lec ##ta ##sis in the ling ##ula and left lower lobe . the effusion could be due to hem ##othorax in the setting of recent splenic rupture . persistent right basilar ate ##lec ##ta ##sis and possible small right pleural effusion . diffuse haz ##iness throughout the upper abdomen is consistent with known ascites on ct of 1 day earlier .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are stable . the patient has taken a better inspiration and the bilateral pulmonary opac ##ifications are less prominent and the cost ##oph ##ren ##ic angles sharp ##er . pleural calcification is again seen .
pred: 3. correct value: 0
a moderate to large right pleural effusion and mild pulmonary edema is new since _ _ _ .
pred: 3. correct value: 0
in comparison to _ _ _ chest radiograph , there has been little change in the appearance of the chest except for new patchy bib ##asi ##la ##r opac ##ities , most likely due to patchy ate ##lec ##ta ##sis although aspiration and an early focus of infectious pneumonia are additional considerations . short - term followup radiographs may be helpful in this regard .
pred: 3. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um , and pleural surfaces .
pred: 1. correct value: 0
the right lung base ventilation for reduced ate ##lec ##ta ##sis . persist left base ate ##lec ##ta ##sis and bilateral small pleural effusion , larger to the left . heart size is minimally larger , probably for increased pericardial effusion . these findings raise concern for post - peric ##ardi ##otomy syndrome . there is no pulmonary edema . there is no pneumothorax . findings were reported to dr _ _ _ at 3 : 35 pm by dr _ _ _
pred: 3. correct value: 1
greater opac ##ification in the left lower chest is probably due to increasing left pleural effusion , responsible in part for return of the cardiac sil ##hou ##ette to the midline , even though there still substantial left lower lobe ate ##lec ##ta ##sis . mild pulmonary vascular congestion is new . heart size is normal . there is no pneumothorax . endotracheal tube is obscure ##d by spinal stabilization rods . it probably still ends substantially above the upper margin of the clav ##icles . as before , the loop of nas ##ogastric tubing in the upper midline could be in the hypop ##har ##yn ##x , although the tube ends in the low stomach . no pneumothorax . dr . _ _ _ was page ##d at 9 : 28 a . m . to report these findings .
pred: 3. correct value: 1
stat read was called to dr . _ _ _ by dr . _ _ _ at 10 : 11 am , at the time of discovery , via telephone .
pred: 1. correct value: 0
1 . resolved right lower lobe collapse and effusion . 2 . increased lower lobe opac ##ities , likely aspiration . 3 . copd .
pred: 3. correct value: 0
og tube tip and side - port lie below the diaphragm , overlying the stomach . continued left lower lobe collapse and / or consolidation . a small left effusion cannot be excluded . mild upper zone redistribution and slight vascular bl ##urring , without overt chf , similar to prior . 9 . 7 mm metallic density overlying the soft tissues lateral to the left mid chest wall - - ? artifact overlying the patient versus a new foreign body . notification : findings regarding the small metallic density adjacent to the left chest wall were discussed by dr . _ _ _ with dr . _ _ _ , one of the covering clinicians in the cc ##u , by phone , _ _ _ min after discovery at 21 : 02 on _ _ _
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the monitor and support devices remain in place . there has been a decrease in the degree of right pneumothorax with substantial re - expansion of the right lung . monitoring and support devices remain in place . postoperative changes on the left are similar to the previous study . basilar opac ##ification at the right base has increased , consistent with layer ##ing effusion and volume loss in the lower lung . again , it would be difficult to radiographic ##ally exclude developing pneumonia on either side .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there are lower lung volumes . there is increased eng ##or ##ge ##ment of ill defined pulmonary vessels , consistent with the clinical diagnosis of pulmonary edema . increased opac ##ification in the retro ##car ##di ##ac region with sil ##hou ##etting of the hemi ##di ##aph ##ragm is consistent with left pleural effusion and substantial volume loss in the lower lobe .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
abdomen and pelvis .
pred: 1. correct value: 0
there has been no change in the chest since at least _ _ _ . patient has had median stern ##otomy . stern ##al wires are intact and aligned . heart size is top - normal . lungs are clear . there is no pleural abnormality . vertebral bodies in the thoracic spine are intact .
pred: 3. correct value: 1
persistent opac ##ity in the right lower lobe is likely ate ##lec ##ta ##sis but superimposed infection cannot be excluded .
pred: 3. correct value: 0
low lung volumes with superimposed mild edema . no definite focal consolidation .
pred: 1. correct value: 0
subtle patchy opac ##ity at the medial right lung base best seen on the frontal view may be due to overlap of vascular structures although underlying aspiration is not excluded in the appropriate clinical setting .
pred: 3. correct value: 0
improvement of mild pulmonary edema and vascular congestion since _ _ _ . unchanged small left pleural effusion .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
cardiac sil ##hou ##ette is no longer enlarged , and pulmonary and mediastinal venous eng ##or ##ge ##ment have improved substantially . there is no pleural effusion , pulmonary edema or pneumothorax . feeding tube passes into the duodenum and out of view . a dual - channel left supra ##cl ##avi ##cu ##la ##r dialysis catheter ends in the right atrium , and right pic ##c line travers ##es a brach ##io ##cephal ##ic venous stent , terminate ##s at the origin of the sv ##c or lower , obscure ##d by the dialysis catheter . no pneumothorax .
pred: 3. correct value: 1
likely small left pleural effusion , seen best on the lateral view . no acute cardiopulmonary process .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there again are scattered calcified lesions consistent with old granulomas . no evidence of acute pneumonia , vascular congestion , pleural effusion .
pred: 1. correct value: 0
no acute findings .
pred: 1. correct value: 0
interval placement of pig ##tail catheter with essentially complete radiographic clearing of the left effusion . no pneumothorax detected . extensive opac ##ity in the left lung , corresponding to the extensive air ##space consolidation / abscess on the _ _ _ ct scan is slightly different in appearance , but overall similar . right middle lobe consolidation seen on the recent ct is not well visualized radiographic ##ally . severe background copd , with dense apical calcifications again noted .
pred: 3. correct value: 0
right internal jugular catheter termin ##ating in the mid sv ##c . no pneumothorax . subtle opac ##ity in the right cardio ##ph ##ren ##ic angle could represent an early pneumonia . correlate with physical exam . follow - up with repeat chest radiograph can be obtained as clinically indicated . notification : updated findings were communicate ##d via telephone by dr . _ _ _ to dr . _ _ _ at 10 : 20 on _ _ _ .
pred: 1. correct value: 0
right pic ##c line terminate ##s at the level of lower sv ##c . bilateral pleural effusion ##s and right lung consolidation ##s are unchanged . mediastinal contours are stable .
pred: 3. correct value: 0
since a recent radiograph of 2 days earlier , pulmonary vascular congestion and mild edema have the improved . right pleural effusion appears slightly smaller with persistent adjacent right middle and right lower lobe opac ##ities . on the left , there is worsening retro ##car ##di ##ac opac ##ification , possibly on the basis of pleural effusion and ate ##lec ##ta ##sis , but underlying infectious process is also possible in the appropriate setting .
pred: 3. correct value: 0
heart size top - normal , decreased since _ _ _ . normal pulmonary vasculature . lungs clear . no pleural abnormality .
pred: 3. correct value: 1
no acute intrath ##oracic process . no definite rib fracture identified .
pred: 1. correct value: 0
moderate to severe pulmonary edema accompanied by small pleural effusion ##s . follow - up chest radiograph after di ##uresis would be helpful to document resolution and to exclude other underlying abnormalities .
pred: 3. correct value: 0
pa and lateral chest compared to _ _ _ : lungs are fully expanded . a small portion of the right major fis ##su ##re is highlighted by either fluid or adjacent consolidation projecting over the right third anterior rib and intersp ##ace . this could be a very small region of pneumonia . left lung is clear . heart size is normal . mediastinal contour suggesting enlargement of the main pulmonary artery is long ##standing . heart size is normal .
pred: 3. correct value: 2
recent chest radiograph . no new focal air ##space opac ##ity to suggest pneumonia .
pred: 1. correct value: 0
left pneumothorax .
pred: 1. correct value: 0
no change .
pred: 1. correct value: 0
minimal left apical pneumothorax is suspected . left chest tube is in unchanged position . the rest of the findings are identical to _ _ _ radiograph obtained and 21 : 06
pred: 3. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
no acute pulmonary process identified .
pred: 1. correct value: 0
previous examination of _ _ _ did not show similar changes . does patient have history of severe thorax trauma during that time ? acute parenchymal infiltrates in left upper lobe ling ##ula as well as right lower lobe posterior segment are probably new . . followup chest examination of the described new acute parenchymal infiltrates is recommended after treatment .
pred: 2. correct value: 0
reex ##pan ##si ##on of the right lung status post chest tube placement .
pred: 1. correct value: 0
basilar ate ##lec ##ta ##sis . non - specific air - fluid levels in the epig ##astric region .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . no radio ##pa ##que foreign body identified .
pred: 1. correct value: 0
no relevant change as compared to the previous image . left pector ##al pacemaker in situ . normal size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta . no pneumonia , no pulmonary edema , no pneumothorax .
pred: 1. correct value: 2
stre ##ak ##y left lower lobe ate ##lec ##ta ##sis . no pulmonary edema .
pred: 1. correct value: 0
moderate pulmonary edema , not substantially changed in the interval , with small bilateral pleural effusion ##s , larger on the right . more focal bib ##asi ##la ##r air ##space opac ##ities , more so within the right lung base , concerning for superimposed infection .
pred: 3. correct value: 0
likely within the stomach . no evidence of pneum ##omed ##ias ##tin ##um or subd ##ia ##ph ##ragm ##atic free air .
pred: 3. correct value: 0
a right internal jugular port - a - cath and trache ##ostomy tube remain in satisfactory position . overall cardiac mediastinal contours are stable . the patient ' s mandible obscure ##s the lung apic ##es . however , the lungs appear well inflated without evidence of focal air ##space consolidation to suggest pneumonia or aspiration at this time . no pleural effusion ##s . no pulmonary edema .
pred: 3. correct value: 0
limited study due to low lung volumes . no acute findings .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
in comparison with the study _ _ _ _ _ _ , low lung volumes again accent ##uates the transverse diameter of the heart . ate ##lec ##ta ##tic changes are again seen at the bases , especially on the left .
pred: 3. correct value: 1
1 . no acute cardiopulmonary process . 2 . chronic changes , as described above . no significant change since the prior radiographs from _ _ _ .
pred: 3. correct value: 0
as compared to _ _ _ radiograph , cardio ##medi ##astin ##al contours are stable . lungs are clear , with no new areas of consolidation to suggest the presence of pneumonia .
pred: 3. correct value: 0
comparison to _ _ _ . new right - sided central venous access line . the tip projects over the cav ##oa ##trial junction . no complications , notably no pneumothorax . the radiograph
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
new left lower lobe opac ##ity could represent ate ##lec ##ta ##sis or pneumonia . mild edema . a repeat chest radiograph is recommended after adequate treatment to document resolution .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
source for infection .
pred: 1. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
resolved .
pred: 1. correct value: 0
suggestive of developing pneumonia . otherwise , right lower lobe opac ##ity appears relatively stable .
pred: 2. correct value: 0
no substantial interval change from the previous ct . persistent bilateral pleural thickening , worse on the left , compatible with mesothelioma . mild pulmonary vascular congestion with left lower lobe consolid ##ative opac ##ity potentially ate ##lec ##ta ##sis , but infection is not excluded .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
right internal jugular central line , endotracheal tube and nas ##ogastric tube are unchanged in position . overall cardiac and mediastinal contours are stable . no pulmonary edema . increasing patchy opac ##ity at the left base could reflect worsening ate ##lec ##ta ##sis , but given the focal ##ity , would be concerning for aspiration or pneumonia . right lung is grossly clear . possible small layer ##ing left effusion . no pneumothorax , although the sensitivity to detect pneumothorax is diminished given semi - supine technique .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are unchanged . diffuse opac ##ification is again seen in the right hemi ##th ##orax , consistent with the clinical diagnosis of pneumonia . obsc ##uration of the hemi ##di ##aph ##ragm is consistent with layer ##ing effusion and compressive ate ##lec ##ta ##sis at the base . less prominent changes are seen at the left base . some of the increased opac ##ification on the right could be a manifestation of asymmetric edema .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the small left apical pneumothorax is again seen . continued promin ##ence of the cardiac sil ##hou ##ette with minimal if any elevation of pulmonary venous pressure . ate ##lec ##ta ##tic changes are seen at the right base .
pred: 3. correct value: 1
mild subs ##eg ##mental ate ##lec ##ta ##sis at the left lung base , otherwise normal chest radiographs .
pred: 3. correct value: 0
1 . do ##bb ##ho ##ff tube ends in the stomach . 2 . endotracheal tube is 1 . 5 cm above the car ##ina . it could be pulled back to avoid bronchial intubation . _ _ _ ( _ _ _ ) was page ##d at 14 : 00 on _ _ _ to convey the findings .
pred: 1. correct value: 0
as compared to the previous radiograph , the extent of the right pleural effusion has decreased . the effusion is better appreciated on the lateral than on the frontal radiograph . subsequent parenchymal opac ##ities at the right lung base , associated to the pleural effusion and likely ate ##lec ##ta ##tic in origin , show several air bronch ##ograms . no new parenchymal opac ##ities . normal diameter of the cardiac sil ##hou ##ette . no pneumothorax .
pred: 1. correct value: 2
in comparison with the study of _ _ _ , the pig ##tail catheter has been removed and there is now a chest tube in place . no evidence of a pneumothorax . the loc ##ulated opac ##ification adjacent to the left lateral chest wall has decreased . postoperative changes are again seen at the left base . there is a stre ##ak of ate ##lec ##ta ##sis in the right mid zone . blunt ##ing of the cost ##oph ##ren ##ic angle could reflect some pleural fluid on this side .
pred: 3. correct value: 0
as compared to the previous radiograph , the patient has received a nas ##ogastric tube . the course of the tube is unremarkable , the tip of the tube projects over the pre - pylori ##c parts of the stomach . no complications . the transparency of the lung bases has increased . however , bilateral parenchymal opac ##ities are still visualized . unchanged appearance of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
probable trace bilateral pleural effusion ##s . no pulmonary edema .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
low lung volumes with right basilar ate ##lec ##ta ##sis . no pulmonary edema .
pred: 1. correct value: 0
comparison to _ _ _ . low lung volumes . mild pulmonary edema . no pleural effusion ##s . mild fluid overload but no overt pulmonary edema . no pneumonia . mild elongation of the descending aorta .
pred: 3. correct value: 0
left port - a - cath terminate ##s in the low sv ##c . no pneumothorax . notification : the findings were discussed by dr . _ _ _ with _ _ _ _ _ _ the telephone ##on _ _ _ at 2 : 53 pm , 3 minutes after discovery of the findings .
pred: 1. correct value: 0
as compared to _ _ _ , the patient is now intu ##ba ##ted . the tip of the endotracheal tube projects approximately 3 . 5 cm above the car ##inal . the patient has also received the nas ##ogastric tube . the course of the tube is unremarkable . the tip projects over the middle parts of the stomach . the previously placed right pic ##c line is in unchanged correct position . lung volumes remain low . mild progression of are pre - existing retro ##car ##di ##ac ate ##lec ##ta ##sis . borderline size of the cardiac sil ##hou ##ette without overt pulmonary edema .
pred: 3. correct value: 1
the extent of mild postoperative mediastinal and cardiac wide ##ning is unchanged since _ _ _ . mild pulmonary edema and moderate to large left and moderate right pleural effusion ##s have increased . no pneumothorax . et tube in standard placement , with the chin down . dual channel left supra ##cl ##avi ##cu ##la ##r central venous catheter ends in the left brach ##io ##cephal ##ic vein . right trans ##jug ##ular sw ##an - gan ##z catheter tip is in the region of the pul ##mon ##ic valve . upper enteric drainage tube passes into the stomach and out of view .
pred: 3. correct value: 0
lungs are chronically extremely abnormal , but there is relatively little change since _ _ _ . the chronic collapse around severe bronchi ##ect ##asis in the right upper lobe is the most prominent feature . bronchi ##ect ##asis and peri ##bronchial infiltration obsc ##uring the left heart border is minimally worse today than before , but within the range that could be artifact ##ual rather than real . lungs elsewhere show the same degree of hyper ##infl ##ation , bronchi ##ect ##asis and scarring . the heart is top normal size . of note , despite the lack of radiographic correspondence with clinical findings , i think it is still reasonable to evaluate the patient ' s changing circumstances with conventional radiographs first , before repeating chest ct scans .
pred: 3. correct value: 2
1 . no acute cardiac or pulmonary process . 2 . no evidence of free air under the diaphragm .
pred: 3. correct value: 0
new ng tube enters the stomach with its side - port near the ge junction . advancement by 2 - 3 cm is advised . new bib ##asi ##la ##r air ##space opac ##ities may be due to ate ##lec ##ta ##sis or aspiration . notification : the ng tube position was discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 11 : 03 am , 10 minutes after discovery of the findings .
pred: 3. correct value: 0
there is no pneumothorax or detectable pleural effusion since _ _ _ : 36 a . m . following removal of the right pleural tube . left pleural tube still in place . mild thickening of the right apical pleural margin has not changed . the right apical consolidation , most likely a pulmonary cont ##usion is improved since 5 a . m . , not much changed since _ _ _ : 30 a . m . heart size normal . left lung clear .
pred: 3. correct value: 2
in comparison with the study of _ _ _ , the endotracheal tube and nas ##ogastric tube have been removed . obl ##iqu ##ity of the patient makes it difficult to properly evaluate the heart and lungs . however there is again substantial enlargement of the cardiac sil ##hou ##ette with pulmonary vascular congestion and bilateral pleural effusion ##s with volume loss in the lower lungs , especially on the left . in view of the extensive changes and absence of a lateral view , it would be impossible to exclude superimposed pneumonia .
pred: 3. correct value: 1
1 . opac ##ity in the right lung base and to a lesser extent the left lung base , which may represent ate ##lec ##ta ##sis but cannot exclude pneumonia or aspiration in the right clinical setting . 2 . free air under the diaphragm , decreased from prior exam .
pred: 3. correct value: 0
pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
limited examination . patchy retro ##car ##di ##ac opac ##ity may reflect ate ##lec ##ta ##sis however infection is not excluded in the correct clinical setting .
pred: 1. correct value: 0
lung volumes are consistently low and the heart chronically moderately enlarged . relatively stable interstitial pulmonary abnormality in the left mid lung , most prominently could be a chronic infiltr ##ative lung disease . full ##ness in the right trache ##ob ##ron ##chi ##al angle of the mediastin ##um could be dist ##ended az ##yg ##os vein , related to portal hypertension , or adeno ##path ##y . if liver transplant is conte ##mp ##lated , then the patient should have a chest ct scan to evaluate these abnormalities . i see no evidence of pneumonia currently .
pred: 3. correct value: 1
1 . right ij in appropriate positioning . 2 . resolution of mild interstitial pulmonary edema .
pred: 2. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are clear . there is no pleural effusion or pneumothorax .
pred: 3. correct value: 2
in comparison with the study of _ _ _ , there is little change in the appearance of the sw ##an - gan ##z catheter , which extends to the right pulmonary artery at the outer border of the mediastin ##um . no change in the appearance of the heart and lungs and pace ##r device .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
heart size is normal . aorta is tort ##uous . bib ##asi ##la ##r opac ##ities likely represent a combination of ate ##lec ##ta ##sis and scarring , and note is also made of a small left pleural effusion , but no visible pneumothorax .
pred: 3. correct value: 2
the left basilar chest tube has been removed . there is a right ij central line with the distal lead tip at the cav ##oa ##trial junction . heart size is within normal limits . there is unchanged basilar subs ##eg ##mental ate ##lec ##ta ##sis . no pneum ##otho ##ra ##ces are seen .
pred: 3. correct value: 2
normal heart , lungs , hil ##a , mediastin ##um , and pleural surfaces . in addition to healed rib fractures , there may any areas where sclerosis and small lytic lesions are found , characteristic ##ally , the left third rib posteriorly , presumably metastases in various stages of treatment . spine is not fully assessed by this single frontal view .
pred: 1. correct value: 0
patchy left basilar opac ##ity likely reflects ate ##lec ##ta ##sis in the setting of low lung volumes , but infection cannot be completely excluded . minimal blunt ##ing of the left cost ##oph ##ren ##ic sulcus could suggest a trace left pleural effusion . diffuse skeletal metastases .
pred: 3. correct value: 0
right basal consolidation has improved . small right pleural effusion is new . severe left lower lobe consolidation unchanged , but lymph ##ovenous congestion in the left upper lobe has improved substantially since _ _ _ . left bronchial stent and left thorac ##ostomy tube still in place . no appreciable pneumothorax . moderate left pleural effusion and pleural thickening persist .
pred: 3. correct value: 0
possible left lower lobe pneumonia in the appropriate clinical context .
pred: 2. correct value: 0
left subcl ##avi ##an pic ##c line with tip in the lower sv ##c .
pred: 2. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
left lung base , concerning for pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
acute appearing fracture of the posterior left fourth rib . nond ##is ##place ##d left third rib fracture better seen on ct .
pred: 2. correct value: 0
clear lungs with no evidence of pneumonia .
pred: 1. correct value: 0
effusion , unchanged .
pred: 1. correct value: 0
1 . mild pulmonary edema is worse than on _ _ _ . 2 . moderate to large left - sided pleural effusion is increased from _ _ _ .
pred: 1. correct value: 0
cardio ##me ##gal ##y is substantial . mediastinal sil ##hou ##ette is stable . lungs are essentially clear . there is no pleural effusion or pneumothorax .
pred: 2. correct value: 1
in comparison with the study of _ _ _ , the monitoring and support devices have been removed . following left chest tube removal , there is no evidence of pneumothorax . elevation of the left hemi ##di ##aph ##ragm ##atic contour is consistent with pleural fluid and volume loss in the left lower lobe . the right lung appears clear and there is no evidence of vascular congestion .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
tiny right apical pneumothorax with interval decrease .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
subtle basilar opac ##ities likely relate to ate ##lec ##ta ##sis in the setting of low lung volumes .
pred: 1. correct value: 0
interval improvement . no pneumothorax
pred: 1. correct value: 0
as compared to the previous radiograph , the pre - existing diffuse parenchymal opac ##ities have minimally decreased at the level of the lung bases . in the remaining lung parenchyma , the opac ##ities are unchanged . unchanged evidence of bronchi ##ect ##asis . no pleural effusion ##s . no cardio ##me ##gal ##y .
pred: 1. correct value: 2
tip of the new feeding tube , with a wire style ##t still in place ends just beyond the gastroesophageal junction . right internal jugular introduce ##r in standard position following removal of sw ##an - gan ##z catheter . lateral aspect of left hemi ##th ##orax is excluded from the examination . small right pleural effusion has enlarged . no pneumothorax . right basal ate ##lec ##ta ##sis has worsened . large pleural calcifications noted . heart size normal . no pneumothorax .
pred: 3. correct value: 2
bulky mediastinal lymphadenopathy is comparable to recent ct . no pulmonary or osseous abnormalities concerning for additional metastatic disease .
pred: 3. correct value: 0
there are no prior chest radiographs available for review . this study is read in conjunction with images of the lower lungs on a cta _ _ _ . disparity in radio ##den ##si ##ty between the upper and lower lungs is probably due to emphysema , but mild interstitial lung disease may be present as well . there is no focal pulmonary abnormality . heart size is normal . pleural surfaces are normal . the ct showed considerable right hil ##ar and adjacent mediastinal adeno ##path ##y which warrant further evaluation recommendation ( s ) : assessment of right hil ##ar and mediastinal adeno ##path ##y , and pulmonary disease , emphysema and possible interstitial lung disease .
pred: 3. correct value: 2
compared to chest radiographs _ _ _ through _ _ _ at 04 : 56 . lungs remain extremely low in volume and the widespread infiltr ##ative abnormality which worsened between _ _ _ and _ _ _ is still present . et tube is in standard placement . nas ##ogastric drainage tube ends in the upper stomach . pleural effusion is small if any . no pneumothorax .
pred: 3. correct value: 0
moderate left pleural effusion persists . mild pulmonary edema has worsened . heart size is normal mediastinal veins are not dist ##ended . tip of the trache ##ostomy tube abut ##s the left tracheal wall , as it has occasionally in the past and should be evaluated to see if positioning is appropriate . left pic line ends in the upper sv ##c . no pneumothorax . a skin fold in the right upper chest should not be mist ##aken for the pleural edge .
pred: 3. correct value: 1
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
patchy left base opac ##ity is re - demonstrated , similar on the frontal view and has been present since at least _ _ _ , however , finding may be slightly increased on the lateral view and underlying ate ##lec ##ta ##sis or subtle superimposed consolidation not excluded .
pred: 3. correct value: 0
as compared to the previous radiograph , the left chest tube is still coiled an shows unchanged appearance as compared to the comparison image . the monitoring and support devices are constant . relatively extensive bilateral pleural effusion ##s persist . peri ##hi ##la ##r evidence of mild to moderate pulmonary edema . moderate cardio ##me ##gal ##y . areas of bilateral basilar ate ##lec ##ta ##sis , no new focal parenchymal opac ##ities . no pneumothorax .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there has been placement of a nas ##ogastric tube that extends into the upper stomach . the side - port is difficult to see , but probably is close to the esophag ##ogastric junction . little overall change in the appearance of the heart and lungs . cardiac sil ##hou ##ette is at the upper limits of normal or mildly enlarged with mild elevation of pulmonary venous pressure and tort ##uo ##si ##ty of the descending aorta .
pred: 3. correct value: 1
no evidence of infection .
pred: 1. correct value: 0
flatten ##ing of the diaphragm compatible with known history of copd . there are no new consolidation ##s or nodules . stable right lower lobe bronchial wall thickening might be due to chronic airway inflammation . cardio ##medi ##astin ##al sil ##hou ##ette is normal . there is no pneumothorax or pleural effusion .
pred: 3. correct value: 0
clear lungs .
pred: 1. correct value: 0
no acute cardiopulmonary process
pred: 1. correct value: 0
1 . interval removal of the right internal jugular central line with placement of a right subcl ##avi ##an pic ##c line with its tip at the cav ##oa ##trial junction . second peripheral line is seen overlying the right axi ##ll ##a with its tip projecting over the brach ##io ##cephal ##ic vein . left chest tube remains in place and a trache ##ostomy tube has its tip at the thoracic inlet , unchanged . a small left apical pneumothorax is seen . no right pneumothorax . there is subcutaneous emphysema within the chest wall which is somewhat diminished since the prior study of _ _ _ . probable small layer ##ing bilateral effusion ##s . stable mild peri ##hi ##la ##r edema . mid left clav ##icular fracture and minimally displaced fracture of the left second anterior rib again identified . overall cardiac and mediastinal contours are stable .
pred: 3. correct value: 0
interval slight improvement of bilateral interstitial opac ##ities .
pred: 1. correct value: 0
1 . opac ##ity in the right hemi ##th ##orax could be right middle lobe pneumonia , or more likely an artifact of pec ##t ##us exc ##ava ##t ##um . as a result , oblique views are recommended for further evaluation . 2 . small retro ##st ##er ##nal nodule can also be further assessed on oblique views .
pred: 2. correct value: 0
increased in intravascular pressure or volume without evidence of pulmonary edema .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has received a nas ##ogastric tube . the course of the tube is unremarkable , the side hole is at the level of the gastroesophageal junction . status post abdominal surgery with potential free air under the right hemi ##di ##aph ##ragm . unchanged alignment of stern ##al wires of the cabg . borderline size of the cardiac sil ##hou ##ette . no pleural effusion ##s . no pulmonary edema .
pred: 3. correct value: 1
ate ##lec ##ta ##sis . mild pulmonary edema . repeat chest radiograph after resolution of right pleural effusion is recommended to reass ##ess the lungs and mediastin ##um .
pred: 3. correct value: 0
effusion ##s and retro ##car ##di ##ac consolidation , likely ate ##lec ##ta ##sis or pneumonia .
pred: 1. correct value: 0
mild pulmonary vascular congestion .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
allowing for differences in technique and projection , there has not been a relevant change in the appearance of the chest since the recent study performed earlier the same date .
pred: 1. correct value: 0
cardio ##me ##gal ##y , otherwise unremarkable .
pred: 1. correct value: 2
pa / lateral radiographs are recommended .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . no pneumothorax identified . 2 . hyper ##infl ##ated lungs with chronic appearing changes suggesting copd . 3 . possible small pleural effusion ##s , left greater than right .
pred: 1. correct value: 0
possible slight pulmonary vascular eng ##or ##ge ##ment without overt pulmonary edema .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
enteric tube tip mid stomach
pred: 1. correct value: 0
1 . there is interval development of small ( left greater than right ) pleural effusion ##s when compared to _ _ _ chest radiograph . however there are no consolidation ##s nor opac ##ities to suggest pneumonia .
pred: 3. correct value: 0
left greater than right basilar opac ##ities are concerning for pneumonia . given the bilateral ##ity , aspiration is a consideration .
pred: 2. correct value: 0
1 ) equivocal slight worsening of the opac ##ity in the right upper zone . otherwise , no interval change identified . 2 ) compared to a radiograph from _ _ _ , the opac ##ity in the right upper zone has improved , as have changes at the right cardio ##ph ##ren ##ic region .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
lung low lung volumes with probable small left pleural effusion .
pred: 1. correct value: 0
there are no prior chest radiographs available for review . cardiac sil ##hou ##ette is severely enlarged due to marked cardio ##me ##gal ##y and / or pericardial effusion . upper lobe pulmonary vessels are mildly eng ##or ##ged , but there is no pulmonary edema , mediastinal venous eng ##or ##ge ##ment , or pleural effusion .
pred: 3. correct value: 1
no mediastinal wide ##ning or focal consolidation . notification : no mediastinal wide ##ning or focal consolidation .
pred: 3. correct value: 0
1 . interval improvement of right lower lobe opac ##ity and stable left lower lobe opac ##ity raising concern for findings related to improving pulmonary edema though superimposed pneumonia cannot be completely excluded . 2 . intra - aortic balloon pump terminate ##s in the lower thoracic aorta with well - positioned sw ##an - gan ##z catheter . stable mild pulmonary edema . recommendation ( s ) : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 11 : 42 am , 5 minutes after discovery of the findings .
pred: 3. correct value: 0
small left pleural effusion , perhaps slightly increased from the prior study , with associated left basilar ate ##lec ##ta ##sis .
pred: 3. correct value: 0
moderate left pleural effusion slightly larger . previous widespread pulmonary abnormality a large . . heart size top - normal . no central venous catheter .
pred: 3. correct value: 1
ng tube tip is in the stomach . et tube tip is 6 cm above the car ##inal . cardio ##medi ##astin ##al sil ##hou ##ette is stable and there is interval development of mild vascular congestion
pred: 1. correct value: 0
as compared to _ _ _ , cardio ##medi ##astin ##al contours are stable and unchanged . bilateral patchy and linear foci of ate ##lec ##ta ##sis are new . free intraperitoneal air is consistent with recent abdominal surgery .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
compare to prior chest radiographs since _ _ _ , most recently _ _ _ . patient has had median stern ##otomy and mitral and aortic valve replacements . even accounting for differences in radiographic technique , the _ _ _ of the cardiac sil ##hou ##ette have increased since _ _ _ common due to worsening cardio ##me ##gal ##y and / or pericardial effusion . there is no pulmonary edema or indication of substantial pleural effusion .
pred: 3. correct value: 1
mild basilar ate ##lec ##ta ##sis , otherwise unremarkable exam .
pred: 1. correct value: 0
normal heart , lungs , hil ##a , mediastin ##um , and pleural surfaces . no evidence of intrath ##oracic malignancy or infection .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
tip of endotracheal tube terminate ##s approximately 10 cm above the car ##ina and should be advanced by several cm for standard positioning . cardio ##medi ##astin ##al contours are stable compared to recent ct of earlier the same date . patchy and linear bib ##asi ##la ##r ate ##lec ##ta ##sis are present with otherwise clear lungs . please see ct report for additional findings including possible left fifth anterior rib fracture and bilateral small pulmonary nodules .
pred: 3. correct value: 0
no acute cardiopulmonary process or evidence of pneumonia .
pred: 1. correct value: 0
the tip of the endotracheal tube projects 2 . 4 cm from the car ##ina . new patchy bilateral air ##space opac ##ities likely reflect pulmonary edema .
pred: 1. correct value: 0
minimal left basilar ate ##lec ##ta ##sis .
pred: 1. correct value: 0
double tube is in the stomach . heart size and mediastin ##um are unchanged . multifocal consolidation ##s , bilateral are similar with minimal improvement in the left peri ##hi ##la ##r area . border appears to be fid ##uc ##ial markers are projecting and unchanged areas .
pred: 2. correct value: 3
from prior exam . otherwise unchanged chest radiograph .
pred: 1. correct value: 0
as compared to the previous radiograph , there is a minimal increase in diameter of the vascular structures , likely reflecting increased fluid overload . no other changes . the multiple known calcifications are constant in appearance . in the interval , the patient has received a trache ##ostomy tube . there is no pneumothorax .
pred: 3. correct value: 0
mildly increased right infra ##hi ##la ##r linear opac ##ities , likely prominent vessels as also noted on the radiograph date ##d _ _ _ , no definite focal consolidation is identified .
pred: 1. correct value: 0
1 . overall stable position of the right - sided central venous catheters . 2 . indis ##tin ##ct right hemi ##di ##aph ##ragm , which may be related to ate ##lec ##ta ##sis and layer ##ing pleural effusion .
pred: 3. correct value: 0
1 . poorly defined consolidation in left upper and left lower lobes concerning for multifocal pneumonia . recommend followup chest x - ray in four weeks after completion of antibiotic therapy to ensure resolution and exclude neoplasm , especially since the left upper lobe opac ##ities have a nodular configuration . 2 . suspected co - existing interstitial edema may also be re - assessed on followup chest radiograph . 3 . small bilateral pleural effusion ##s with likely component of co - existing pleural thickening on the left .
pred: 3. correct value: 0
there has been interval marked worsening of ate ##lec ##ta ##sis in the right lower lobe and right middle lobe . right chest tube is kink ##ed at the skin entrance . moderate left effusion has increased . cardio ##me ##gal ##y and wide ##ned mediastin ##um are unchanged . ng tube tip is out of view below the diaphragm . right pic ##c tip is in the upper sv ##c .
pred: 3. correct value: 1
no comparison . the lung volumes are low . moderate cardio ##me ##gal ##y with mild pulmonary edema . no pneumonia , no pleural effusion ##s .
pred: 3. correct value: 1
no acute cardiac or pulmonary findings .
pred: 1. correct value: 0
ate ##lec ##ta ##sis . however , if pulmonary symptoms concerning for pneumonia are present , then short - term followup radiographs could be considered with better inspiration .
pred: 2. correct value: 0
compared to prior chest radiographs _ _ _ . lung volumes are lower despite tracheal intubation . et ##t tip is no less than 15 mm from the car ##ina the actual distance is distorted by patient positioning . trachea is not actually quite short and et ##t positioning will require periodic radiographic confirmation . poor definition of the lower tracheal and right bronchial airway could be due to retained secretions . clinical correlation advised . no definite pulmonary edema or evidence of pneumonia . new small left pleural effusion is likely . no pneumothorax .
pred: 3. correct value: 0
1 . new moderate pulmonary venous congestion . 2 . worsening bilateral lower lobe collapse .
pred: 1. correct value: 0
unchanged from the prior exam . there are no new consolidation ##s . right ##ward shift of the mediastin ##um is stable and reflects volume loss on the right . the left lung is clear . there is no definite pleural effusion , although one on the right cannot be excluded . there is no pneumothorax . the cardio ##medi ##astin ##al sil ##hou ##ette is normal in size . unchanged right middle and lower lobe pneumonia .
pred: 3. correct value: 0
1 . feeding tube and right subcl ##avi ##an central line are unchanged in position . there are layer ##ing bilateral effusion ##s , some associated patchy air ##space disease which has somewhat improved suggesting resolving ate ##lec ##ta ##sis . overall , cardiac and mediastinal contours are stable . no pneumothorax or pulmonary edema .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . minimally improved . ventilation of the retro ##car ##di ##ac lung regions . unchanged left apical postoperative changes . the diffuse parenchymal opac ##ities on the right are also constant .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitor and support devices are essentially unchanged . there is increased haz ##iness of the left hemi ##th ##orax , consistent with pleural effusion and compressive volume loss involving the left lower lobe . the pulmonary vessels are less distinct , consistent with increasing pulmonary vascular congestion . the area of opac ##ification suggested in the right upper lung on the previous study is now clear , indicating that it had nearly represented overlying scap ##ula .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no significant interval change of bilateral pleural effusion ##s . these limit evaluation for underlying parenchymal opac ##ity / possibility of infection .
pred: 1. correct value: 0
1 . stable mild to moderate pulmonary edema . 2 . worsening opac ##ities in the right lung base concerning for pneumonia . 3 . rounded pulmonary nodules bilaterally are partially evaluated on ct in _ _ _ . results telephone ##d to dr . _ _ _ by dr . _ _ _ at 3 : 10 pm , _ _ _ , _ _ _ min after discovery .
pred: 1. correct value: 0
large left pleural effusion increased since _ _ _ . left lower lobe still air ##less . central adeno ##path ##y is demonstrated on yes ##ter ##day ' s chest ct is not as readily apparent on this conventional radiograph . heart size is top - normal . nas ##ogastric tube passes into the stomach and out of view . no pneumothorax
pred: 3. correct value: 1
1 . no acute cardiopulmonary process . 2 . no rib fracture is seen on this non - dedicated study .
pred: 2. correct value: 0
1 . right - sided port - a - cath unchanged in position . lungs are slightly lower in volume , but no focal air ##space consolidation is seen to suggest pneumonia . no evidence of pulmonary edema , pleural effusion ##s or pneumothorax . overall , cardiac and mediastinal contours are stable . two linear opac ##ities are seen projecting over the left scap ##ula which are of uncertain clinical significance but may be external to the patient as these were not seen on the prior study of _ _ _ ; clinical correlation is advised .
pred: 3. correct value: 0
hyper ##infl ##ated lungs without focal consolidation .
pred: 1. correct value: 0
as compared to the previous radiograph , the lung volumes have decreased . moderate cardio ##me ##gal ##y with enlargement of the left ventricle and elongation of the descending aorta . no overt pulmonary edema . no pneumonia , no pleural effusion ##s .
pred: 3. correct value: 1
heart size is normal . mediastin ##um is normal . lungs are _ _ _ volumes as compared to the prior study with increase in basal opac ##ities , potentially due to suboptimal inspiratory effort . does repeated radiograph in full inspiration is recommended . there is no pleural effusion and there is no pneumothorax .
pred: 3. correct value: 2
small left pleural effusion .
pred: 1. correct value: 0
1 . right internal jugular central line continues to have its tip in the proximal right atrium near the cav ##oa ##trial junction . the patient is status post median stern ##otomy with stable post - operative cardiac and mediastinal contours . there are small bilateral effusion ##s , left greater than right with associated patchy air ##space process , likely reflecting partial lower lobe ate ##lec ##ta ##sis . no evidence of pulmonary edema . no pneumothorax .
pred: 3. correct value: 0
previously asymmetrical ##ly distributed opac ##ification in the right lung base and upper lobe has improved , but interstitial abnormality has become considerably more extensive in the left lung and there is new consolidation at the base . the findings could be explained by asymmetric distribution of edema , but i favor aspiration , clearing from the right lung , now worsening on the left . generalized hyper ##infl ##ation is due to obstructive airways disease . borderline cardio ##me ##gal ##y is stable . pleural effusion ##s if present are not large .
pred: 3. correct value: 1
do ##bb ##ho ##ff feeding tube ending in the mid esophagus should be removed or reposition ##ed .
pred: 1. correct value: 0
subs ##eg ##mental ate ##lec ##ta ##sis in the right lower lobe . no free air under the diaphragm ##s .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
right pic ##c line tip terminate ##s at the cav ##oa ##trial junction . cardio ##me ##gal ##y is moderate , unchanged . promin ##ence of the main pulmonary arteries consistent with pulmonary hypertension . there is interval progression of right basal opac ##ity , most likely representing ate ##lec ##ta ##sis but infection is a possibility . vascular congestion has increased and concerns for volume overload . no overt pulmonary edema .
pred: 3. correct value: 1
the car ##ina . no acute cardiopulmonary findings .
pred: 1. correct value: 0
mild cardio ##me ##gal ##y , similar when compared to prior . no superimposed acute cardiopulmonary process .
pred: 2. correct value: 1
as compared to the previous radiograph , the patient has received a left pector ##al pacemaker . the leads project over the right atrium and right ventricle respectively . there is no pneumothorax . unchanged symmetrical bilateral apical thickening , with small calcifications . unchanged extent of a pre - existing left pleural effusion with mild retro ##car ##di ##ac ate ##lec ##ta ##sis . no pulmonary edema . no pneumonia .
pred: 3. correct value: 0
edema although , given the lack of change , acuity is uncertain .
pred: 1. correct value: 0
1 . small bilateral pleural effusion ##s and possible left lower lobe consolidation which is somewhat difficult to assess given underp ##ene ##trated technique . consider dedicated pa and lateral views for further assessment . 2 . metallic linear density within the soft tissues of the right axi ##ll ##a appears to represent a foreign body and was seen on the prior radiograph date ##d _ _ _ but not on the previous radiograph date ##d _ _ _ . please correlate for interventions in this region and associated symptoms .
pred: 3. correct value: 0
no radiographic evidence of pneumonia .
pred: 1. correct value: 0
moderate to large left pleural effusion has grown substantially since _ _ _ and left lung consolidation has worsened to the point where the left lung is virtually air ##less . this looks like a combination of ate ##lec ##ta ##sis and pneumonia . the differential diagnosis of new right lower lobe consolidation is the same . mediastin ##um remains shifted to the left common the left heart border is obscure ##d . no pneumothorax . trache ##ostomy tube midline . notification : dr . _ _ _ reported the findings to dr . _ _ _ by telephone on _ _ _ at 3 : 34 pm , 1 minutes after discovery of the findings .
pred: 3. correct value: 0
consolidation in the right supra ##hi ##la ##r region is compatible with pneumonia in the proper clinical setting . however , repeat after treatment is suggested to document resolution and exclude underlying mass lesion .
pred: 1. correct value: 0
the small - to - moderate right pneumothorax , largely apical , has not changed since 7 : 24 a . m . , the apex of the right lung is at the level of the third posterior intersp ##ace with separation of the lateral surfaces to the level of the sixth rib . moderately severe right basal ate ##lec ##ta ##sis , mild left basal ate ##lec ##ta ##sis , and small bilateral pleural effusion have not appreci ##ably changed . the heart size is normal . the upper left lung is clear . dr . _ _ _ was page ##d .
pred: 3. correct value: 2
pic ##c line in appropriate position .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . a new mediastinal bulge could be a hi ##atus hernia . if the diagnosis is not known , the patient should have a contrast swallow or oral contrast and a repeat lateral view .
pred: 1. correct value: 0
substantial bilateral pleural effusion , right greater than left , persists despite the bilateral pig ##tail pleural drainage catheters . moderate pulmonary edema is increasing , even though heart size is normal . severe infra ##hi ##la ##r consolidation in both lungs could be infection or ate ##lec ##ta ##sis . no pneumothorax . right jugular line ends in the low sv ##c .
pred: 3. correct value: 2
subtle focal opac ##ity in the left lower lung likely corresponds to infectious focus identified on previous ct of the abdomen and pelvis from _ _ _ .
pred: 1. correct value: 0
ate ##lec ##ta ##sis . no evidence of acute pneumonia .
pred: 1. correct value: 0
moderate right pleural effusion has worsened from prior studies . severe bull ##ous emphysema without evidence of residual pneumothorax .
pred: 1. correct value: 0
no acute cardiopulmonary process . non ##urge ##nt chest ct is suggested to evaluate the bilateral nodular opac ##ities present on recent chest x - ray but new since _ _ _ .
pred: 2. correct value: 0
no convincing evidence for pneumonia .
pred: 1. correct value: 0
no comparison . the lung volumes are normal . borderline size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta . increase in interstitial structures , notably in the peri ##hi ##la ##r areas , suggesting interstitial edema . no pleural effusion ##s . no no pneumonia .
pred: 3. correct value: 1
clear lungs with elevation of the right hemi ##di ##aph ##ragm , which is new since the prior radiograph from _ _ _ , and may represent phr ##enic nerve injury , or an intra - abdominal process resulting in elevation of the hemi ##di ##aph ##ragm .
pred: 1. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are overall clear . elevated right hemi ##di ##aph ##ragm is similar to previous examination . there is gradual interval improvement of posterior consolidation ##s .
pred: 3. correct value: 2
the lung volumes are normal . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures . minimal bilateral apical thickening . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 3. correct value: 2
mildly over ##infl ##ated lungs . no focal pneumonia or pneumothorax .
pred: 1. correct value: 0
1 . no radiographic evidence of metastatic disease in the thorax . 2 . a right - sided port - a - cath is unchanged in position , termin ##ating in the mid _ _ _ of the sv ##c , approximately 4 . 5 cm in the cav ##oa ##trial junction .
pred: 3. correct value: 0
as compared to the previous image , there is minimally improved transparency of the right basal lung , potentially reflecting improved ventilation of this lung area . otherwise , the diffuse bilateral parenchymal opac ##ities , associated with small pleural effusion ##s and retro ##car ##di ##ac ate ##lec ##ta ##sis , are constant in extent and severity . no new opac ##ities . unchanged size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
no comparison . low lung volumes . moderate cardio ##me ##gal ##y . signs of mild to moderate pulmonary edema . small right pleural effusion . no pneumonia .
pred: 3. correct value: 1
there is consolidation of the medial aspect of the left lower lobe which may represent ate ##lec ##ta ##sis or an early pneumonia . i get the impression of volume loss which favors ate ##lec ##ta ##sis . please take note of the low position of the et ##t .
pred: 3. correct value: 0
since the recent radiograph of 1 day earlier , the patient has undergone right thorac ##ente ##sis with reduction in size of right pleural effusion and no visible pneumothorax . multifocal bilateral areas of air space consolidation show slight interval improvement . no other relevant change .
pred: 3. correct value: 0
heart size is normal . mediastin ##um is normal . lungs are clear . there is no pleural effusion or pneumothorax .
pred: 3. correct value: 2
right apical pneumothorax is essentially unchanged .
pred: 1. correct value: 0
right ij catheter tip is in the lower sv ##c . right pic ##c tip is in the cav ##oa ##trial junction . radiol ##uce ##nt area underneath the right hemi ##di ##aph ##ragm represented in prior study colonic air . there is no pneumothorax . mild cardio ##me ##gal ##y is stable . extensive bilateral opac ##ities larger on the left are unchanged . there are small to moderate bilateral pleural effusion ##s better seen in ct .
pred: 3. correct value: 1
1 . interval slight decrease in size of left pleural effusion . 2 . unchanged small right pleural effusion .
pred: 3. correct value: 0
ate ##lec ##ta ##sis , however pneumonia cannot be excluded .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
asymmetrical ##ly more so on the right than on the left . these findings could be related to either pulmonary edema versus atypical infection . clinical correlation suggested .
pred: 1. correct value: 0
no focal consolidation to suggest pneumonia .
pred: 1. correct value: 0
subcutaneous emphysema is severe in the thorac ##oa ##bd ##om ##inal wall and neck . i do not see pneum ##omed ##ias ##tin ##um for certain , and no pneumothorax , though i suspect this is not an erec ##t chest radiograph which would be required to exclude that . lung volumes are quite low , exagger ##ating what is probably mild edema seen best on the right , and mild cardio ##me ##gal ##y . large mediastinal lymph node calcification in the ap window is noted . dr . _ _ _ was page ##d to recommend repeat examination primarily to exclude pneumothorax .
pred: 3. correct value: 1
right ij cv ##l termin ##ating in the lower sv ##c . no pneumothorax .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process . no focal consolidation to suggest pneumonia .
pred: 1. correct value: 0
findings suggesting fluid overload . persistent shadow projecting over the right upper thorax , which raises concern for the possibility of an unusual imaging appearance of pneumothorax ; although doubt ##ed , chest ct are short - term followup radiograph should be considered to exclude the diagnosis , in addition to correlation with whether there has been any recent prior history of instrumentation .
pred: 3. correct value: 0
as above .
pred: 1. correct value: 0
lungs grossly clear . heart size normal . pleural effusion small on the left if any . previous nas ##ogastric feeding tube has been removed .
pred: 3. correct value: 2
in comparison with the earlier study of this day , there has been shift of the cardiac sil ##hou ##ette to the left with no evidence of obl ##iqu ##ity of the patient . although there is not extensive opac ##ification in the retro ##car ##di ##ac region , the appearance is strongly suggestive of volume loss in the left lower lobe , possibly due to a mucous plug . notification : this information was immediately convey ##ed by telephone to dr . _ _ _ , _ _ _ related that the clinical picture could well represent partial obstruction secondary to a mucous plug .
pred: 3. correct value: 1
no pneumonia .
pred: 1. correct value: 0
moderate bilateral pleural effusion ##s and adjacent areas of opac ##ity probably attributable to compressive ate ##lec ##ta ##sis . mild pulmonary edema .
pred: 1. correct value: 0
an enteric tube terminate ##s in the stomach . otherwise , no acute cardiopulmonary process in the visualized lungs .
pred: 1. correct value: 0
small left pleural effusion has increased since the chest ct , perhaps even since the abdomen ct on _ _ _ . pulmonary metastases are difficult to the to see on conventional radiographs , but a small number are visible , including _ _ _ - 20 mm wide and lesions most evident on the lateral view . the left pleural effusion could be malignant . since esophageal surgery was more than 6 months ago , it is less likely to be a ch ##yl ##ous effusion related to esophag ##ectomy . aside from the lung nodules lungs are essentially clear . cardio ##medi ##astin ##al sil ##hou ##ette has a an unremarkable bowel postoperative appearance . the esophag ##ogastric stent is unchanged in position since at least _ _ _ . there is no pneumothorax .
pred: 3. correct value: 0
comparison to _ _ _ . mildly increasing right basilar ate ##lec ##ta ##sis . otherwise unchanged radiograph . minimal fluid overload is still present . moderate cardio ##me ##gal ##y persists . the ventricular assist device is in stable position .
pred: 3. correct value: 1
et and og tubes positioned appropriately . mild hil ##ar congestion and mild right basal ate ##lec ##ta ##sis .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ at 17 : 27 . 5 cm long tracheal stent ends no less than one cm the car ##ina , but distance is either distorted by patient positioning . stent cal ##iber is intact . endotracheal tube cannula ##tes the upper _ _ _ % of the stent . right pic line ends in the low sv ##c . heart size partially obscure ##d by a heavy but bilateral heterogeneous consolidation , infection unchanged since _ _ _ , is at least mildly enlarged and unchanged . small pleural effusion ##s are presumed . no pneumothorax . .
pred: 1. correct value: 3
small left pleural effusion . no acute cardiopulmonary abnormality otherwise demonstrated .
pred: 3. correct value: 0
mild bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 0
new small left pleural effusion . no evidence of pneumonia . of note subtle infection may only be seen on ct scan . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the telephone on _ _ _ at 8 : 53 am , 5 minutes after discovery of the updated findings .
pred: 1. correct value: 0
endotracheal tube tip is 5 cm above the car ##ina . nas ##ogastric tube tip is beyond the ge junction tip and extends beyond the edge of the film . there is a new small left effusion . there is ate ##lec ##ta ##sis in the left lung base . there is no chf or pneumothorax .
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ through _ _ _ . decrease in the volume of air in the loc ##ulated left posterior hydro pneumothorax . overall volume of left pleural effusion probably smaller . consolidation in the left lung is difficult to assess , grossly unchanged . right lung is grossly clear . cardiac sil ##hou ##ette is larger . pulmonary vasculature is eng ##or ##ged in the upper lobes , but there is no pulmonary edema . no pneumothorax .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
pulmonary vascular eng ##or ##ge ##ment , without focal consolidation or pleural effusion .
pred: 1. correct value: 0
no pneumonia or acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
mild to moderate pulmonary edema has changed in distribution but not in overall severity . moderate left pleural effusion is tip substantially larger . heart size normal . no pneumothorax . nas ##ogastric tube ends in the upper stomach .
pred: 3. correct value: 2
subtle lower lung opac ##ities concerning for a very early pneumonia .
pred: 1. correct value: 0
clearing of previously identified parenchymal opac ##ities .
pred: 1. correct value: 0
the comparison with the previous study , there is again substantial enlargement of the cardiac sil ##hou ##ette consistent with a nonh ##em ##orrh ##agic pericardial effusion seen on recent ct . opac ##ification at the left base is consistent with pleural effusion and volume loss the left lower lobe , flow in the appropriate clinical setting superimposed pneumonia or aspiration would have to be seriously considered . the right lung is essentially clear . the do ##bb ##ho ##ff tube extends to the lower body of the stomach .
pred: 3. correct value: 1
no significant interval change .
pred: 1. correct value: 0
comparison , but findings could relate to prior trauma . left basilar ate ##lec ##ta ##sis without definite focal consolidation .
pred: 2. correct value: 0
comparison to _ _ _ . normal lung volumes . normal size of the heart . normal hil ##ar and mediastinal contours . no pneumonia , no pulmonary edema , no pleural effusion ##s .
pred: 3. correct value: 2
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . the bilateral areas of basal ate ##lec ##ta ##sis persist . however , the pre - existing right basal opac ##ity is better delineated than on the previous image , now raising the suspicion for aspiration pneumonia . otherwise unchanged radiograph . no pleural effusion ##s . mild cardio ##me ##gal ##y . no pulmonary edema .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette is at the upper limits of normal or mildly enlarged . however , no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
no acute cardiopulmonary process . no pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
ct on _ _ _ : postoperative lung volumes are quite low , and bib ##asi ##la ##r opac ##ification is more likely ate ##lec ##ta ##sis than aspiration , but should be followed . small pleural effusion ##s are presumed . there is no pneumothorax . right apical pleural tube in standard position . the exact position of a second longer drain that travers ##es the midline is uncertain . clinical correlation advised . heart size is exaggerated by low lung volumes , and there is minimal if any mediastinal wide ##ning .
pred: 3. correct value: 1
1 . re - expansion of left pneumothorax and worsening left subcutaneous emphysema . 2 . worsening left lower lobe opac ##ification . notification : the findings were discussed with dr . _ _ _ by _ _ _ _ _ _ , m . d . on the telephone on _ _ _ at 1 : 41 pm , 10 minutes after discovery of the findings .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
of pneumonia .
pred: 1. correct value: 0
1 . persistent residual scattered nodular densities suggestive of chronic aspiration . 2 . hi ##atal hernia .
pred: 2. correct value: 0
et tube ends just at the level of the lower margin of the clav ##icles with the head elevated , no less than 53 mm from the car ##ina , standard placement . nas ##ogastric tube ends in the upper stomach . right lung clear . heart size normal . focal pleural thickening or small effusion lies adjacent to the cardiac apex . no pneumothorax .
pred: 3. correct value: 2
low lung volumes . elevated right hemi ##di ##aph ##ragm . peri ##hi ##la ##r opac ##ities raising concern for mild pulmonary edema . patchy basilar opac ##ities most likely relate to edema , however , infectious process not excluded in the appropriate clinical setting . dedicated pa and lateral views or frontal view within improved inspiration would be helpful for further evaluation .
pred: 1. correct value: 0
no acute process .
pred: 1. correct value: 0
moderate left pleural effusion with overlying ate ##lec ##ta ##sis , underlying consolidation not excluded . similar pulmonary edema .
pred: 1. correct value: 0
chronic elevation of the right hemi ##di ##aph ##ragm . no definite superimposed acute cardiopulmonary process .
pred: 1. correct value: 0
since _ _ _ , unchanged right port - a - cath and left - sided pacemaker . no acute cardiopulmonary process .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is again a right hil ##ar mass with the lower parat ##ra ##che ##al adeno ##path ##y . however , otherwise there is little interval change and increased expansion of the lungs .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette remains at the upper limits of normal in size or slightly enlarged . little if any vascular congestion . given the low lung volumes in scatter radiation related to the size of the patient , no definite acute focal pneumonia is appreciated .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the lung volumes have slightly decreased . as a consequence , areas of plate ##li ##ke ate ##lec ##ta ##sis have newly appeared at the lung bases . in addition , on the right , the presence of a small pleural effusion cannot be excluded . the size of the cardiac sil ##hou ##ette is at the upper range of normal . minimal fluid overload but no overt pulmonary edema . no evidence of pneumonia .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there are slightly lower lung volumes . the left chest tube remains in place and there is no definite pneumothorax . nas ##ogastric tube again extends into the stomach . retro ##car ##di ##ac opac ##ification is consistent with volume loss in the left lower lobe and small pleural effusion . dense stre ##ak of ate ##lec ##ta ##sis is again seen in the left lower zone . some indis ##tin ##ct ##ness of pulmonary vessels is consistent with elevated pulmonary venous pressure . dilatation of the colon in the region of the splenic flex ##ure is again seen .
pred: 3. correct value: 0
minimal ate ##lec ##ta ##sis in the right lung base . no evidence for pneumonia or congestive heart failure .
pred: 3. correct value: 0
suspicious for infection , either bacterial or fungal . cross - sectional imaging would be useful in evaluating the full extent of infection . otherwise , followup chest radiograph after treatment is recommended . these findings were discussed with dr . _ _ _ by dr . _ _ _ at 09 : 18 on _ _ _ by telephone by _ _ _ min after discovery .
pred: 1. correct value: 0
no significant interval change since the prior exam .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
mild interval increase in left pleural effusion . no change in cardiac sil ##hou ##ette size .
pred: 3. correct value: 1
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
1 . no acute cardiopulmonary process . specifically no pneumonia . 2 . degenerative changes of thoracic spine . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ _ _ _ , m . d . on the telephone on _ _ _ at 4 : 20 pm , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
there are no prior chest radiographs available for review . lungs are fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal . .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . moderate cardio ##me ##gal ##y and left lower lobe ate ##lec ##ta ##sis persist . the monitoring and support devices are constant . normal appearance of the right lung . no pneumothorax . no pulmonary edema .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little overall change in the appearance of the heart and lungs . again there are bilateral pleural effusion ##s with basilar ate ##lec ##ta ##tic changes , more prominent on the right . substantial enlargement of the cardiac sil ##hou ##ette with relatively mild vascular congestion . this raises the possibility of cardiomyopathy or pericardial effusion .
pred: 3. correct value: 1
a right internal jugular central line with its tip in the mid sv ##c . endotracheal tube continues to have its tip approximately 2 . 8 cm above the car ##ina . nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip likely within the stomach . a left subcl ##avi ##an pic ##c line also has its tip in the superior vena cava . overall , cardio ##medi ##astin ##al contours are stable , although difficult to assess due to the diffuse interstitial air ##space process , which is essentially unchanged and may represent chronic interstitial changes , although a superimposed acute infectious process or pulmonary edema cannot be excluded . no pneumothorax .
pred: 1. correct value: 0
slight interval improvement in mild pulmonary edema .
pred: 1. correct value: 0
no relevant change as compared to the previous image . mild elongation of the descending aorta . normal size of the cardiac sil ##hou ##ette . no pleural effusion ##s . no pneumonia , no pulmonary edema . no pneumothorax .
pred: 3. correct value: 2
large hi ##atal hernia with adjacent ate ##lec ##ta ##sis . stre ##ak ##y left base opac ##ities are likely due to combination of hi ##atal hernia and ate ##lec ##ta ##sis .
pred: 2. correct value: 0
compared to prior chest radiographs , since _ _ _ , most recently _ _ _ . mild pulmonary edema has improved substantially . residual opac ##ification at the right lung base could be dependent edema and ate ##lec ##ta ##sis but should be followed to exclude pneumonia since it preceded the worsening of edema yes ##ter ##day . more trou ##bles ##ome is a region of nond ##ep ##endent heterogeneous opac ##ification in the left mid ##lu ##ng which should also be followed as possible pneumonia . severe cardio ##me ##gal ##y stable . ind ##welling , right trans ##jug ##ular dialysis catheter set ends in the low sv ##c and right atrium .
pred: 3. correct value: 1
comparison to _ _ _ . no relevant change . no suspicious pulmonary nodules or masses . no pleural effusion ##s . normal size of the heart . mild elongation of the descending aorta .
pred: 3. correct value: 2
compared to chest radiographs _ _ _ through _ _ _ . lung volumes remain quite low . pulmonary vascular eng ##or ##ge ##ment and mild pulmonary edema worse in the left lung on the right . left pic line has been reposition ##ed in the low sv ##c . heart size top - normal . small left pleural effusion stable . no pneumothorax .
pred: 3. correct value: 1
compared to chest radiographs since _ _ _ , most recently _ _ _ . mild pulmonary edema is new . severe cardio ##me ##gal ##y , mediastinal venous and pulmonary vascular congestion of all worsened . small pleural effusion ##s are presumed . no pneumothorax et tube is cured by external device , may not be positioned sufficiently low . trans ##esophageal drainage tube has been reposition ##ed in the stomach . recommendation ( s ) : evaluate et tube position clinically or repeat chest radiograph with no overlying device to obscure it .
pred: 3. correct value: 1
pacemaker leads in appropriate position . no pneumothorax .
pred: 3. correct value: 0
as compared to _ _ _ , the patient has been intu ##ba ##ted with endotracheal tube in standard position . heart is upper limits of normal in size and accompanied by mild pulmonary vascular congestion .
pred: 3. correct value: 0
1 . pulmonary edema with small pleural effusion ##s . 2 . pic ##c line tip at the cav ##oa ##trial junction or within the right atrium . consider slight retraction .
pred: 1. correct value: 0
increased fluid overload
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
adjacent ate ##lec ##ta ##sis .
pred: 1. correct value: 0
large left pleural effusion has mildly increased . adjacent ate ##lec ##ta ##sis have increased . there is mild vascular congestion . there is no evident pneumothorax . left pig ##tail catheter in unchanged position . no other interval change from prior study .
pred: 1. correct value: 0
no acute cardiopulmonary process . stable chest x - ray .
pred: 1. correct value: 0
elevated .
pred: 1. correct value: 0
bilateral foot pleural effusion ##s are larger , with underlying collapse and / or consolidation . otherwise , doubt gross change .
pred: 3. correct value: 0
no pneumothorax or pulmonary edema . previous vascular congestion in the lungs is resolved . small left pleural effusion may be new . ate ##lec ##ta ##sis is not significant . normal cardio ##medi ##astin ##al sil ##hou ##ette
pred: 3. correct value: 0
no clear evidence of pneumonia , however , the chest is better evaluated on the subsequent ct .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
interval removal of lines and tubes . no pneumothorax detected . increased retro ##car ##di ##ac opac ##ity compared to the prior study , consistent with increase in left lower lobe collapse and / or consolidation . probable small bilateral effusion ##s . increased opac ##ity in the left greater right parat ##ra ##che ##al region and at the lung apic ##es , improving compared with _ _ _ . clinical correlation is requested .
pred: 3. correct value: 0
middle lobe pneumonia . differential includes pcp and atypical infection .
pred: 1. correct value: 0
mid and lower lung in the same distribution as prior multifocal pneumonia concerning for recurrent multifocal pneumonia . concurrent mild interstitial edema . results were discussed over the telephone with dr . _ _ _ by _ _ _ _ _ _ at 4 p . m . on _ _ _ at time of initial review .
pred: 1. correct value: 0
the pulmonary nodules appear stable in size compared to prior however looking back they have grown considerably . the left upper lung nodule has grown from 8 to 22 mm since _ _ _ . the right upper lung nodule has grown from 2 mm to 14 mm since _ _ _ .
pred: 1. correct value: 0
interval improvement of the bilateral mild pulmonary edema . interval improvement of the right lung base ate ##lec ##ta ##sis and right small pleural effusion .
pred: 1. correct value: 0
moderate to severe cardio ##me ##gal ##y is stable . allowing the difference in positioning of the patient large bilateral effusion ##s with adjacent ate ##lec ##ta ##sis are unchanged . moderate pulmonary edema is unchanged . enlargement of the main pulmonary arteries is again noted suggesting pulmonary hypertension .
pred: 3. correct value: 1
compared to chest radiographs _ _ _ through _ _ _ . worsening opac ##ification at the base of the left lung with slight ipsilateral mediastinal shift is probably new lower lobe collapse . elevation right lung base and multiple right lung nodules due to carcinoma and / or complications . previous mediastinal wide ##ning has improved . no pneumothorax . mild enlargement of cardiac sil ##hou ##ette has decreased . right central venous catheter ends in the region of the superior cav ##oa ##trial junction .
pred: 3. correct value: 1
1 . supportive devices are in appropriate position . 2 . no focal parenchymal opac ##ity . no evidence of pneumothorax .
pred: 2. correct value: 0
small left - sided pleural effusion , also with adjacent ate ##lec ##ta ##sis . no pneumothorax .
pred: 1. correct value: 0
stre ##ak ##y opac ##ity projecting over the lower lung fields on the lateral view , not seen on the frontal view , similar appearance to chest radiographs from _ _ _ , may relate to ate ##lec ##ta ##sis / scarring and possibly adjacent osteop ##hy ##tes .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of active or latent tb .
pred: 1. correct value: 0
1 . large left and small right pleural effusion ##s , with adjacent ate ##lec ##ta ##sis . 2 . mild cardio ##me ##gal ##y is stable .
pred: 3. correct value: 1
the upper left pleural drainage catheter has been partially withdrawn , and a new lower tube inserted . the overall volume of moderate residual left pleural effusion is unchanged since _ _ _ pm , but substantially smaller than it was prior to pleural drainage . mediastin ##um is still shifted slightly to the right . the large cardio ##medi ##astin ##al sil ##hou ##ette is unchanged . previous pulmonary edema has resolved , but vascular eng ##or ##ge ##ment persists in the right lung . there is no pneumothorax . left jugular line ends in the low sv ##c .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the patient has taken a better inspiration . the cardiac sil ##hou ##ette remains at the upper limits of normal or mildly enlarged . minimal indis ##tin ##ct ##ness of pulmonary vessels suggests some elevated pulmonary venous pressure . no evidence of acute focal pneumonia or pleural effusion .
pred: 3. correct value: 1
right param ##edia ##st ##inal opac ##ity , may indicate pneumonia in the right clinical setting .
pred: 1. correct value: 0
worsening right pleural effusion . stable positioning of bilateral chest tubes .
pred: 1. correct value: 0
no evidence of pneumonia .
pred: 1. correct value: 0
mild pulmonary vascular congestion , unchanged . no acute cardiopulmonary abnormality otherwise identified .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
extensive infiltr ##ative pulmonary abnormality has not changed for several days . heart size top - normal . pleural effusion small any . no pneumothorax . right pic line can be traced as far as the origin of the right brach ##io ##cephal ##ic vein , obscure ##d by the right jugular introduce ##r that ends in the mid to low sv ##c . nas ##ogastric tube in standard placement .
pred: 3. correct value: 1
right subcl ##avi ##an pic ##c line and right internal jugular sw ##an - gan ##z catheter unchanged in position . there has been no interval change in the diffuse bilateral parenchymal process which could represent severe pulmonary edema , although pulmonary hemorrhage or a diffuse infectious process could have a similar appearance . clinical correlation is recommended . there is likely a small layer ##ing left effusion . given the diffuse air ##space process , assessment of cardiac and mediastinal contours is difficult . no obvious pneumothorax .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has developed a right upper lobe ate ##lec ##ta ##sis . otherwise the radiograph is unchanged . moderate cardio ##me ##gal ##y . mild to moderate pulmonary edema . low lung volumes . constant position of the monitoring and support devices .
pred: 3. correct value: 1
1 . new opac ##ity right base laterally , likely a combination of a small amount of pleural fluid and focal pneumon ##itis or pneumonia . 2 . increased vascular plethora , consistent with mild chf .
pred: 1. correct value: 3
since the recent study of earlier the same date , a left pig ##tail pleural catheter has been placed with slight decrease in size of small left apical pneumothorax . subcutaneous emphysema in left chest wall is new . no other relevant changes .
pred: 3. correct value: 0
as compared to previous radiograph from less than 2 hr earlier , a nas ##ogastric tube has been replaced or reposition ##ed , with tip termin ##ating in the stomach . no other relevant changes compared to the recent exam .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process . port - a - cath positioned appropriately .
pred: 1. correct value: 0
top normal heart size .
pred: 1. correct value: 2
clear lungs .
pred: 1. correct value: 0
1 . moderate right apical pneumothorax has very minimally decreased since yes ##ter ##day . 2 . right lower lung opac ##ity concerning for aspiration / ate ##lec ##ta ##sis is more dense ##r than before , though not increased in size . small right pleural effusion is unchanged . no new left pleural effusion .
pred: 3. correct value: 0
compared to chest radiographs _ _ _ and _ _ _ : 33 . mild cardio ##me ##gal ##y and mediastinal vascular eng ##or ##ge ##ment , pulmonary vascular eng ##or ##ge ##ment and small right pleural effusion have increased , reflecting volume overload or cardiac decompens ##ation . but there is no appreciable pulmonary edema . ate ##lec ##ta ##sis in the right lower lobe is unchanged . no pneumothorax .
pred: 3. correct value: 1
with associated ate ##lec ##ta ##sis .
pred: 1. correct value: 0
increased small right apical pneumothorax after removal of the right - sided chest tube since _ _ _ . otherwise , no significant change . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ , the referring provider , on the telephone on _ _ _ at 2 : 32 pm , 1 minute after discovery of the findings .
pred: 3. correct value: 0
1 . interval placement of an esophageal stent extending from the stern ##al notch to the level of the mid esophagus 4c ##m below the car ##ina . 2 . slight cranial migration of the left mainst ##em bronch ##us stent with the proximal end now situated in the lower trachea 1c ##m above the car ##ina . notification : findings were discussed with dr . _ _ _ by dr . _ _ _ _ _ _ telephone at 2 : 40 ##pm on _ _ _ , 20 minutes following discovery .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
left lower lobe opac ##ity , concerning for persistent or recurrent pneumonia . recommend repeat radiographs in 4 weeks to document complete resolution after appropriate therapy .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . patchy right basilar opac ##ity , typical for ate ##lec ##ta ##sis . if pulmonary symptoms or present or persist , how ##ver , short - term followup radiographs could be considered to re - evaluate the opac ##ity , preferably with pa and lateral technique , if possible clinically . 2 . nodular focus projecting over the left lung apex , near an ek ##g lead . although likely an artifact , it is difficult to exclude a true pulmonary nodule , and accordingly re - assessment with standard pa and lateral radiographs is recommended , following removal of the ek ##g leads , when clinically appropriate .
pred: 3. correct value: 0
two upper enteric tubes pass into the mid stomach . moderate left pleural effusion and left lower lobe ate ##lec ##ta ##sis may have improved , pulmonary and mediastinal vasculature are less eng ##or ##ged and moderate cardio ##me ##gal ##y has improved . gas in the splenic flex ##ure should not be mist ##aken for pneum ##oper ##itoneum . right jugular line ends in the upper sv ##c . no pneumothorax .
pred: 3. correct value: 1
focal opac ##ity at the right lung base concerning for pneumonia . diffuse background interstitial lung disease , potentially caused by chronic underlying infection .
pred: 2. correct value: 0
re ##accum ##ulation of large left pleural effusion with minimal air component . notification : the findings were discussed with dr . _ _ _ on the telephone on _ _ _ at 1 : 42 pm .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
subcutaneous emphysema in the right supra ##cl ##avi ##cu ##la ##r region has improved substantially over 2 hr , , and persists in smaller volume in the right chest wall . lungs are low in volume but clear . normal cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces .
pred: 3. correct value: 0
as compared to _ _ _ radiograph , a small to moderate left pneumothorax is similar when considerations are made for differences in positioning and lung volumes . left chest tube remains in place . slight worsening of left basilar ate ##lec ##ta ##sis with otherwise similar appearance of the chest .
pred: 3. correct value: 0
no acute intra thoracic abnormality . if concern for left rib fracture persists , dedicated left rib films with a marker indicating site of pain is recommended .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary disease .
pred: 1. correct value: 0
as compared to the previous radiograph , there is almost unchanged appearance of multiple bilateral solid pulmonary nodules , reflecting diffuse metastatic disease . an area of pre - existing parenchymal ate ##lec ##ta ##sis in retro ##car ##di ##ac location is improved . no pleural effusion ##s . no pneumonia , no pulmonary edema . unchanged size and morphology of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
these findings were discussed with dr . _ _ _ by dr . _ _ _ by telephone at 8 : 45 p . m . on _ _ _ .
pred: 1. correct value: 0
in comparison with the earlier study of this date , there is increased opac ##ification at the left base with poor definition of the hemi ##di ##aph ##ragm , reflecting some combination of effusion and volume loss at the left base with possible superimposed aspiration or pneumonia . no convincing evidence of pneumothorax . continued enlargement of the cardiac sil ##hou ##ette with some indis ##tin ##ct ##ness of pulmonary vessels , suggesting elevated pulmonary venous pressure . right subcl ##avi ##an pic ##c line extends to the level of the cav ##oa ##trial junction or possibly the upper portion of the right atrium .
pred: 3. correct value: 1
as compared to _ _ _ chest radiograph , subtle interstitial opac ##ities have apparently increased compared to the prior exam . it is uncertain whether this represents acute interstitial edema or an atypical pneumonia . exam is otherwise unchanged .
pred: 1. correct value: 0
interval wide ##ning of the upper mediastin ##um is probably explained by less erec ##t positioning and increased intravascular volume . careful followup advised . heart is normal size , minimally larger today than on _ _ _ , but there is no pulmonary vascular congestion , edema , or appreciable pleural effusion . no pneumothorax .
pred: 3. correct value: 0
bilateral pleural effusion ##s . findings discussed with dr . _ _ _ by phone at 4 : 10 p . m . on _ _ _ .
pred: 1. correct value: 0
right base opac ##ity could be due to pneumonia and / or ate ##lec ##ta ##sis .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the left chest tube is been removed and there is no evidence of pneumothorax . otherwise , the monitor and support devices are unchanged . the increased opac ##ification at the right base is much less prominent than on the previous study .
pred: 3. correct value: 0
kink ##ing just proximal to the left axi ##ll ##a .
pred: 1. correct value: 0
interval increase in right upper lobe reticular changes and opac ##ification , which could represent interstitial fibrosis in progressive chronic sarcoidosis . however , in the appropriate setting , superimposed acute pneumonia cannot be excluded . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ , the referring provider , on the telephone on _ _ _ at 4 : 40 pm , 1 minute after discovery of the findings .
pred: 1. correct value: 0
heart is upper limits of normal size given ap technique . mediastinal contours are stable . there are scattered radio ##pa ##que nodular opac ##ities within both lungs suggestive of prior granulomatous infection . the peri ##hi ##la ##r vasculature is somewhat prominent . small layer ##ing bilateral effusion ##s suggestive of mild vascular congestion . no overt pulmonary edema . no pleural effusion ##s or pneumothorax . no evidence of focal pneumonia . degenerative changes in the thoracic spine with no acute bony abnormality identified .
pred: 3. correct value: 0
of left main bronch ##us , likely primarily due to acute mucus plug ##ging given rapid development of collapse since recent ct . as discussed with dr . _ _ _ by telephone on _ _ _ at 7 : 45 a . m . at the time of discovery , bronchoscopy would be helpful for both diagnostic and therapeutic purposes , particularly given the presence of soft tissue thickening and irregular ##ity of this bronch ##us on recent ct .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . again there is a right chest tube in place with no evidence of pneumothorax , though there is apical pleural capping consistent with pleural fluid . the band of opac ##ification in the right mid to lower lung could represent collapse of a long segment or possibly fluid in the major fis ##su ##re . the left lung is essentially clear .
pred: 3. correct value: 0
support lines and tubes are unchanged in position . cardio ##medi ##astin ##al sil ##hou ##ette is within normal limits . there is ate ##lec ##ta ##sis at the lung bases , right worse than left . no overt pulmonary edema or focal consolidation is seen . there are no pneum ##otho ##ra ##ces .
pred: 1. correct value: 0
small right pleural effusion has nearly resolved . there is no pneumothorax . right basal ate ##lec ##ta ##sis has improved . left lung clear . heart size normal . right atrial ventricular pace ##r leads are unchanged in position , but localization would require conventional frontal and lateral views . no pneumothorax . as before there is the suggestion of dist ##ention of the upper esophagus and at the thoracic inlet .
pred: 3. correct value: 2
this study .
pred: 1. correct value: 0
residual right middle lobe ate ##lec ##ta ##sis .
pred: 1. correct value: 0
comparison to _ _ _ . massive new parenchymal opac ##ities , in both upper lobes and a right more than left . the presence of air bronch ##ograms is highly suggestive of pneumonia . the pre - existing left basal consolidation , blunt ##ing the cost ##oph ##ren ##ic sinus and the left heart border , is stable .
pred: 1. correct value: 0
linear areas of ate ##lec ##ta ##sis . severe upper lobe emphysema and peripheral small airways disease as described .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison to _ _ _ chest radiograph , there is no relevant change in the appearance of the chest , with no new areas of consolidation to suggest pneumonia .
pred: 1. correct value: 0
in comparison with the earlier study of this date , there is again evidence of right pneumon ##ectomy with shift of the mediastin ##um to this side . continued opac ##ity in the mid and lower portions of the left lung , again most consistent with pneumonia .
pred: 1. correct value: 0
1 . moderate right pleural effusion . 2 . right lower lobe opac ##ity similar to prior chest ct . 3 . right apical pleural thickening and mass seen on prior chest ct . 4 . low lung volumes .
pred: 3. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . previously collapsed right lower lobe has re - expanded , is not fully aer ##ated , but contains sufficient consolidation to raise concern for new pneumonia . lungs otherwise clear . borderline cardio ##me ##gal ##y unchanged . no pneumothorax . et tube in standard placement . nas ##ogastric drainage tube can be traced clearly as far as the low esophagus , but it is probably continuous with a section of tubing that ends in the distal stomach
pred: 3. correct value: 1
a cluster of small nodular opac ##ities has developed in the axillary region of the right mid ##lu ##ng since _ _ _ , probably pneumonia . right lower lobe has been intermittent ##ly ate ##lec ##ta ##tic , but when expanded has shown persistent consolidation . this could be a and another focus of pneumonia . left lower lobe consolidation has worsened since _ _ _ , probably ate ##lec ##ta ##sis . pulmonary vasculature is eng ##or ##ged and heart size remains top - normal . pleural effusion ##s are presumed , but not large . no pneumothorax . et tube in standard placement . trans ##esophageal drainage tube passes into the stomach and out of view .
pred: 3. correct value: 1
normal chest radiographs . notification : these findings were communicate ##d to dr . _ _ _ _ _ _ : 14 p . m . on _ _ _ by phone .
pred: 1. correct value: 0
no pneumothorax following left chest tube removal . no other significant interval change
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . massive enlargement of the pulmonary arteries . minimal to moderate blunt ##ing of the left cost ##oph ##ren ##ic sinus , potentially consistent with a mild to moderate left pleural effusion . no overt pulmonary edema . no pneumonia . left retro ##car ##di ##ac ate ##lec ##ta ##sis .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the elevation of the left hemi ##di ##aph ##ragm has increased . new left pleural effusion . ate ##lec ##ta ##sis at the left lung bases . moderate cardio ##me ##gal ##y . unchanged appearance of the right lung .
pred: 3. correct value: 1
1 . et and ng tubes in standard position . 2 . increasing pulmonary edema , concurrent aspiration pneumonia . 3 . prominent appearance of mediastin ##um , likely secondary to volume overload ; however edema could have substantial non - cardiac component , such as hypotension - induced alveolar damage . please refer to subsequent ct for further details .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
since _ _ _ , a moderate sized right pleural effusion has slightly increased in size . moderate right pneumothorax with apical and basilar components is unchanged , and the remainder of exam is unchanged as well .
pred: 3. correct value: 0
mild to moderate improvement in the multi lob ##ar air ##space consolidation .
pred: 2. correct value: 0
as compared to the previous radiograph , the trache ##ostomy tube is in unchanged position . the pre - existing parenchymal opac ##ities , notably at the left lung base , have minimally decreased in severity . the lung volumes remain low . the presence of a minimal left pleural effusion cannot be excluded . unchanged borderline size of the cardiac sil ##hou ##ette without overt pulmonary edema .
pred: 3. correct value: 1
bilateral pleural effusion ##s and mild pulmonary edema .
pred: 1. correct value: 0
new right middle lobe opac ##ity , wor ##ris ##ome for pneumonia . left lower lobe pulmonary nodule consistent with patient ' s known lung cancer . additional bilateral pulmonary nodules better assessed on ct . possible trace pleural effusion ##s .
pred: 1. correct value: 0
resolution of cardio ##genic pulmonary edema with underlying consolidation within the right middle and left lower lobe concerning for aspiration pneumonia or pneumon ##itis .
pred: 1. correct value: 0
there are persistent low lung volumes . the left hemi ##di ##aph ##ragm is elevated . there is no pulmonary edema , pneumothorax , enlarg ##ing effusion ##s or obvious consolidation ##s . cardiac size cannot be evaluated . the aorta is tort ##uous .
pred: 3. correct value: 1
1 . top normal cardiac sil ##hou ##ette , slightly increased in size .
pred: 1. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
findings suggest pulmonary venous hypertension . enlarged central pulmonary arteries .
pred: 1. correct value: 0
interval improvement
pred: 1. correct value: 0
worsening scattered reticul ##ono ##du ##la ##r opac ##ities wor ##ris ##ome for progressive pneumonia . results were discussed over the telephone with dr . _ _ _ dr . _ _ _ _ _ _ at 10 : 35 on _ _ _ at time of initial review .
pred: 1. correct value: 0
trache ##ob ##ron ##chi ##al stents in unchanged position . no superimposed acute process .
pred: 3. correct value: 0
in comparison to _ _ _ , right middle and right lower lobes are now completely collapsed , likely due to plug ##ging of the bronch ##us intermedi ##us . left lung is clear except for patchy and linear ate ##lec ##ta ##sis at the base .
pred: 3. correct value: 0
residual opac ##ity is likely scarring rather than new pneumonia . no new opac ##ity .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
compared to prior chest radiographs _ _ _ through _ _ _ . patient has been ext ##ubated , but low lung volumes have improved although there is still substantial bib ##asi ##la ##r ate ##lec ##ta ##sis . heart size top - normal . pulmonary vascular congestion is exaggerated by the low lung volumes . there is no pulmonary edema . pleural effusion ##s small if any . no pneumothorax .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
et tube tip is in a standard position . no other interval change from prior study .
pred: 3. correct value: 0
moderate - to - severe cardio ##me ##gal ##y is chronic . moderate right and smaller left pleural effusion have both increased resulting in worsening basal ate ##lec ##ta ##sis . pulmonary vasculature is eng ##or ##ged to the point of edema . no pneumothorax .
pred: 3. correct value: 1
no acute cardiopulmonary process . persistent cardio ##me ##gal ##y . stable position of left sided icd .
pred: 2. correct value: 1
within the limits of study technique , no evidence of cardio ##th ##oracic abnormality . ct may be a more sensitive test to evaluate for metastatic disease process .
pred: 3. correct value: 0
new pulmonary vascular congestion , without evidence of focal consolidation .
pred: 1. correct value: 0
focal mass ##li ##ke opac ##ification within the right lower lobe concerning for neoplasm . diffuse nodular opac ##ities within the right lung may reflect infection or lymphangi ##tic spread of tumor . probable mediastinal lymphadenopathy . further assessment with contrast - enhanced chest ct is recommended .
pred: 3. correct value: 0
in comparison to prior radiograph from earlier the same date , pulmonary vascular congestion has slightly improved . nonspecific bib ##asi ##la ##r opac ##ities have also slightly decreased in extent . no other relevant change in the short time interval between the 2 studies .
pred: 3. correct value: 0
ate ##lec ##ta ##sis in the left mid lung is new . lungs are otherwise clear . no pleural effusion . normal cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes .
pred: 3. correct value: 0
1 . et ##t , right ij , and ng tube in appropriate positioning . 2 . worsening moderate - size left pleural effusion in comparison to prior chest radiograph . 3 . bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
mild pulmonary edema and small bilateral pleural effusion ##s with bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 3. correct value: 0
emphysema with focal linear scar in the left lower lung .
pred: 1. correct value: 0
1 . the presence of air bronch ##ograms within the partially collapsed right middle and right lower lobes may represent mild re - expansion edema versus pneumonia . recommend chest ct for further evaluation . 2 . small right pleural effusion may have slightly improved . 3 . worsening left pleural effusion opac ##ifies the left lower lung . 4 . the cardio ##medi ##astin ##al sil ##hou ##ette cannot be assessed limiting assessment for mediastinal shift and left lob ##ar collapse . recommendation ( s ) : chest ct . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 11 : 39 am , 10 minutes after discovery of the findings .
pred: 3. correct value: 0
in the absence of a lateral , can be a combination of pleural effusion and consolidation , versus involving the chest wall given recent surgery . recommendation ( s ) : suggest pa and lateral radiograph , if this cannot be performed , considered ct thorax .
pred: 3. correct value: 0
low lung volumes . no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
no evidence of pneumonia . right basal ate ##lec ##ta ##sis . stable promin ##ence of the right pulmonary hil ##um , reflecting prominent vasculature . _ _ _ , md cc : dr . _ _ _
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
low lung volumes . no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute findings .
pred: 1. correct value: 0
is not entirely excluded in the appropriate clinical setting .
pred: 1. correct value: 0
acute aspiration or infection . questionable lymphadenopathy in right hil ##ar and subc ##arin ##al regions is difficult to evaluate on lateral cx ##r due to low lung volumes . repeat cx ##r with improved inspiratory level is recommended for initial further evaluation . findings discussed with dr . _ _ _ at 9 : 25 a . m on _ _ _ .
pred: 3. correct value: 0
no previous images . cardiac sil ##hou ##ette is enlarged and there is tort ##uo ##si ##ty of the aorta . do a - channel pace ##r is in place with leads extending to the right atrium and apex of the right ventricle . no evidence of pneumothorax . hypere ##x ##pan ##si ##on of the lungs suggests chronic pulmonary disease , though there is no evidence of acute focal pneumonia .
pred: 3. correct value: 1
1 . rounded inferior lung opac ##ity , only seen on the lateral view , could represent post - operative rounded ate ##lec ##ta ##sis . attention on follow up is recommended if the patient does not have fever . 2 . near resolution of right pleural effusion , now tiny .
pred: 1. correct value: 0
lungs .
pred: 1. correct value: 0
chest tube has been placed at the right base . there remains a right - sided pleural effusion , unchanged . there is ate ##lec ##ta ##sis at the lung bases . heart size is within normal limits . no pneum ##otho ##ra ##ces are seen .
pred: 1. correct value: 2
pulmonary and mediastinal vascular congestion has worsened , lung volumes are lower , making it difficult to say whether mild interstitial edema has developed . . moderate left pleural effusion is larger . moderate to severe left lower lobe ate ##lec ##ta ##sis is unchanged . moderate to severe cardio ##me ##gal ##y is comparable to the preoperative appearance . et tube is in standard placement . right supra ##cl ##avi ##cu ##la ##r dual channel catheter ends low in the right atrium , esophageal drainage tube in the upper portion of a nond ##ist ##ended stomach , left internal jugular line at the origin of the sv ##c . no pneumothorax .
pred: 3. correct value: 1
1 . minimal right lower lobe ate ##lec ##ta ##sis , otherwise no acute cardiopulmonary process . interval near - complete resolution of right pleural effusion . 2 . bony irregular ##ity and resorption of the right distal clav ##icle . correlate for prior trauma .
pred: 3. correct value: 0
the in over development of a large right pleural effusion that occupies approximately _ _ _ % of the right hemi thorax . subsequent right basilar ate ##lec ##ta ##sis . unchanged appearance of the left heart border , normal left lung parenchyma .
pred: 3. correct value: 0
right internal jugular central venous line ends in the mid sv ##c .
pred: 1. correct value: 0
appropriate positioning of a right internal jugular approach central venous catheter without complication . no acute cardiopulmonary abnormality .
pred: 3. correct value: 0
comparison the _ _ _ . on today ' s radiograph , the right pic ##c line shows a normal course , the tip projects over the lower sv ##c . no complications , notably no pneumothorax . no pleural effusion ##s . no pneumonia , no pulmonary edema .
pred: 3. correct value: 0
no previous images . there is a left chest tube following a vat ##s wedge resection with probably a tiny apical pneumothorax . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
as compared to the previous radiograph , no relevant change is seen . the mill ##imetric lateral pneumothorax on the left is constant in appearance . the position of the left pig ##tail catheter is also unchanged . unchanged left pic ##c line . no evidence of tension in the left lung . normal appearance of the right lung . the cardiac sil ##hou ##ette is at the upper range of normal , no signs of pulmonary edema are seen . no substantial pleural effusion ##s have free of correct .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there is little change . cardiac sil ##hou ##ette remains within normal limits and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
as compared to the previous radiograph , the lung volumes have increased , likely reflecting improved ventilation . the alignment of the stern ##al wires , the position of the left pic ##c line and the right hemodialysis catheter are unchanged . moderate retro ##car ##di ##ac ate ##lec ##ta ##sis . borderline size of the cardiac sil ##hou ##ette . improving ate ##lec ##ta ##sis at the right lung bases . no overt pulmonary edema . no focal parenchymal opac ##ities .
pred: 3. correct value: 1
1 . small right apical pneumothorax . 2 . right pleural effusion is grossly unchanged .
pred: 1. correct value: 0
mild cardio ##me ##gal ##y and borderline pulmonary vascular congestion unchanged . no pulmonary edema . no pleural effusion . no pneumothorax .
pred: 3. correct value: 1
right internal jugular central venous catheter terminate ##s in the proximal sv ##c without evidence of pneumothorax . slight blunt ##ing of the left cost ##oph ##ren ##ic angle , possible trace pleural effusion . no focal consolidation .
pred: 3. correct value: 0
1 . interval intubation with the endotracheal tube having its tip approximately 8 cm above the car ##ina . advancement by 3 cm would be recommended . right internal jugular large - bore catheter continues to have its tip in the distal sv ##c near the cav ##oa ##trial junction . left internal jugular central line has its tip in the proximal sv ##c . overall , cardiac and mediastinal contours are stable . patchy opac ##ity at the right base is again seen , likely reflecting ate ##lec ##ta ##sis . improved aer ##ation at the left base . minimal blunt ##ing of the cost ##oph ##ren ##ic angles which could reflect small effusion ##s or chronic pleural thickening . no evidence of a pneumothorax , although the sensitivity to detect a pneumothorax is diminished given supine technique . results were communicate ##d directly to the covering nurse , _ _ _ _ _ _ , by phone on _ _ _ at 11 : 23 a . m . at the time of discovery .
pred: 3. correct value: 0
in the interval , bilateral breast implants have been placed . normal lung volumes . no pneumonia , no pulmonary edema . no pleural effusion ##s .
pred: 1. correct value: 0
the interval increase in cal ##iber of the mediastin ##um between the earliest and the latest examination of _ _ _ has stabilized . whether this represents hemorrhage or mediastinal venous dist ##ention is indeterminate . the lungs look clear aside from mild left lower lobe ate ##lec ##ta ##sis and there is no pneumothorax or pleural effusion . right internal jugular introduce ##r ends above the thoracic inlet . no pneumothorax .
pred: 3. correct value: 0
there has been interval placement of a left internal jugular central line which has its tip in the mid to distal sv ##c . no pneumothorax . the nas ##ogastric tube is seen again cours ##ing below the diaphragm with the tip coiled within the stomach . there are persistent bib ##asi ##la ##r patchy opac ##ities with improved aer ##ation in the right upper lung . findings would be consistent with fluctuating pulmonary edema rather than an infectious process . probable small layer ##ing bilateral effusion ##s . overall cardiac and mediastinal contours are unchanged . a right shoulder replacement is incompletely visualized .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . improvement of mild pulmonary congestion since _ _ _ 2 . right lower lung opac ##ities persist and are concerning for pneumonia .
pred: 3. correct value: 0
right central venous line tip is at the level of cav ##oa ##trial junction . heart size and mediastin ##um are stable . opac ##ity projecting over the left mid lower lung corresponds to a metastatic involvement of the chest better appreciated on the ct chest from _ _ _ . no new consolidation ##s demonstrated . there is no evidence of pulmonary edema but vascular congestion is present .
pred: 1. correct value: 3
normal chest .
pred: 1. correct value: 0
1 . interval increase in size of a small left apical pneumothorax . 2 . increased left basilar opac ##ification , likely representing a layer ##ing pleural effusion .
pred: 3. correct value: 0
tip of the nas ##ogastric tube is in the upper portion of non - dist ##ended stomach , but the tube would need to be advanced 6 cm to move all the side port ##s beyond the gastroesophageal junction . mild interstitial edema and mediastinal vascular congestion have worsened and severe cardio ##me ##gal ##y is more pronounced . pleural effusion ##s are small if any . no pneumothorax .
pred: 3. correct value: 1
1 . tort ##uous ascending aorta with or without a component of dilation . consider ct scan for further evaluation if warranted clinically . 2 . previously seen left hil ##ar full ##ness is likely due to superim ##position of vascular structures .
pred: 3. correct value: 0
no change from 2 days prior .
pred: 1. correct value: 0
low lung volumes with probable bib ##asi ##la ##r ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no relevant change as compared to the previous examination . all monitoring and support devices , including the cardiac assisting device , are constant . constant shape and size of the cardiac sil ##hou ##ette . no change in appearance of the lung parenchyma .
pred: 2. correct value: 1
as compared to the previous radiograph , no relevant change is seen . the monitoring and support devices are constant . moderate cardio ##me ##gal ##y . low lung volumes . mild fluid overload but no overt pulmonary edema . the extent of a pre - existing retro ##car ##di ##ac ate ##lec ##ta ##sis is constant .
pred: 3. correct value: 1
the rapid improvement in opac ##ification at the right base indicates this was dependent edema . there has been some improvement in lymphatic eng ##or ##ge ##ment in the left lung as well . lower lobe remains largely ate ##lec ##ta ##tic and small pleural effusion persists , with pig ##tail pleural drainage catheter still in place . heart is mildly enlarged . left pic line ends in the low sv ##c .
pred: 3. correct value: 0
mild interval improvement in the appearance of the left lung consolidation which persists . as mentioned on prior , followup will be necessary after treatment . trace pleural effusion ##s . no other change .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous image , the extent of the bilateral apical pneum ##otho ##ra ##ces have not substantially changed . the pre - existing moderate cardio ##me ##gal ##y is constant . no evidence of tension . constant position of the right chest tube . the left pic ##c line is positioned in unchanged manner , in a known persistent superior vena cava on the left .
pred: 3. correct value: 1
the heart size may not be abnormal , but the presentation of dyspnea with pulmonary edema raises concern for cardiomyopathy .
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
unchanged ate ##lec ##ta ##sis . asymmetric pulmonary edema is improving .
pred: 1. correct value: 0
displaced left mid clav ##icular fracture . no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change is seen . normal lung volumes . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal structures . no pneumonia , no pulmonary edema , no pleural effusion ##s .
pred: 1. correct value: 2
there are low lung volumes , which accent ##uate the bronch ##ovascular marking ##s . given this , there bib ##asi ##la ##r ate ##lec ##ta ##sis . hil ##ar and peri ##hi ##la ##r opac ##ities may be due to a mild pulmonary edema , again exaggerated by the low lung volumes . no pleural effusion or pneumothorax is seen . cardiac and mediastinal sil ##hou ##ettes are stable .
pred: 3. correct value: 0
minimal residual haz ##iness to the left lung base posteriorly with otherwise interval clearing of pneumonia there . linear opac ##ity at the right middle lobe abut ##ting the anterior aspect of the major fis ##su ##re seen only on lateral view may be the patient ' s baseline .
pred: 3. correct value: 0
chest x - ray examination within normal limits . no pneumon ##ic infiltrate identified .
pred: 1. correct value: 0
ate ##lec ##ta ##sis in the right mid lung , and the left base .
pred: 1. correct value: 0
bilateral extensive air ##space opac ##ities likely reflect pulmonary edema , superimposed infection cannot be excluded .
pred: 2. correct value: 0
low lung volumes with mild pulmonary vascular congestion , small bilateral pleural effusion ##s , and patchy opac ##ities in the lung bases , likely ate ##lec ##ta ##sis though infection is not excluded .
pred: 1. correct value: 0
interval placement of a do ##bb ##ho ##ff tube that terminate ##s in a branch of the right bronchial tree . notification : at the time that this radiograph was read , the mal ##position ##ed do ##bh ##off tube had already been reposition ##ed . please see subsequent cx ##r report .
pred: 3. correct value: 0
effusion ##s . right greater than left basilar opac ##ities which could represent superimposed infection . recommend repeat after treatment to document resolution especially in setting of previously seen right - sided consolidation without documented resolution in the interim .
pred: 3. correct value: 0
the patient is rotated , which may exagger ##ate left ##ward mediastinal shift , but the right pneumothorax is large enough to raise concern for tension physiology much less respiratory impairment . at that time , this study was reviewed , subsequent chest radiograph had been performed at 7 : 30 a . m . showing right apical pleural tube having treated the pneumothorax and reduced right pleural effusion . severe cardio ##me ##gal ##y and left lower lobe ate ##lec ##ta ##sis are essentially unchanged . the et tube is in standard placement . left subcl ##avi ##an line passes to the left brach ##io ##cephal ##ic vein . feeding tube passes in the stomach and out of view .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
subp ##le ##ural nodular opac ##ities at the right peripheral lung apex , better evaluated on prior chest ct from _ _ _ , stable . otherwise , no acute cardiopulmonary process . no focal lung consolidation .
pred: 1. correct value: 0
1 . minimal bib ##asi ##la ##r ate ##lec ##ta ##sis . no acute cardiac or pulmonary process . 2 . no definite rib fractures identified . if there is persistent concern for rib fracture , a dedicated rib series is more sensitive .
pred: 3. correct value: 0
no significant interval change when compared to the prior study .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . the cardiac sil ##hou ##ette remains within normal limits . no definite vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 1. correct value: 2
moderately severe pulmonary edema has changed in distribution , but not in overall severity . greater opac ##ification at the base of the right lung could be explained by pleural effusion , and in the axillary region of the right lung by asymmetric edema , but there is no way to exclude concurrent pneumonia . heart size is only mildly enlarged . small bilateral pleural effusion ##s are presumed . no pneumothorax .
pred: 3. correct value: 1
mild pulmonary vascular congestion with slight interval increase in small bilateral pleural effusion ##s .
pred: 3. correct value: 0
no evidence of intrath ##oracic metastasis .
pred: 1. correct value: 0
pneumothorax .
pred: 1. correct value: 0
patchy left base opac ##ity , which is subtle , could be due to ate ##lec ##ta ##sis although pneumonia is not excluded in the appropriate clinical setting .
pred: 1. correct value: 0
port - a - cath catheter tip is at the level of cav ##oa ##trial junction . cardio ##me ##gal ##y is substantial . mediastinal sil ##hou ##ette is stable . widespread parenchymal opac ##ities appear to be unchanged since the prior study and most likely represent infectious process in pulmonary edema or potentially combination of both . slight improvement in the left lung base is noted that might reflect be improved component of pulmonary edema .
pred: 3. correct value: 1
comparison to _ _ _ . massive decrease in extent and severity of the pre - existing parenchymal consolidation ##s and opac ##ities . moderate cardio ##me ##gal ##y persists . stable monitoring and support devices . stable moderate cardio ##me ##gal ##y .
pred: 3. correct value: 1
left lower lobe opac ##ity concerning for pneumonia .
pred: 1. correct value: 0
compared to _ _ _ , a moderate right pneumothorax has increased in size with chest tube in place . thin - walled cystic luc ##encies at the right lung base may reflect pneum ##ato ##cel ##es or bull ##ae . widespread subcutaneous emphysema at is again demonstrated in the chest wall and has increased in severity . no other relevant changes since the previous exam .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is again no evidence acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion . the soft tissue full ##ness in the region of the esophagus is not definitely appreciated on this study .
pred: 3. correct value: 0
no acute cardiopulmonary process . no pneumothorax identified .
pred: 1. correct value: 0
right internal jugular line with tip termin ##ating upper sv ##c . no pneumothorax .
pred: 1. correct value: 0
no acute cardiopulmonary abnormalities
pred: 1. correct value: 0
1 . promin ##ence of the pulmonary vasculature is improved . no pulmonary edema . 2 . severe dext ##ros ##co ##li ##osis is unchanged .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is no change . no evidence of acute cardiopulmonary disease or old tuberc ##ulous disease .
pred: 3. correct value: 0
in comparison with the study of earlier in this date , there is little interval change . there are lower lung volumes with diffuse interstitial abnormalities involving both lungs . in view of the known interstitial lung disease , it is difficult to determine whether there is superimposed congestive failure .
pred: 3. correct value: 0
lungs fully expanded and clear . cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes and pleural surfaces are normal , including slight lateral convex ##ity to the right supra cardiac mediastin ##um , probably a tort ##uous aorta .
pred: 2. correct value: 0
1 . no pneumonia . 2 . new small bilateral pleural effusion ##s . 3 . widespread bony metastases .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
nodular opac ##ities within the right lung may reflect vessels on end although infectious etiology is difficult to exclude .
pred: 1. correct value: 0
as compared to the previous radiograph , the pre - existing right pleural effusion has almost completely resolved . a minimal amount of effusion is seen on the lateral radiograph only . overall smaller lung volumes . no cardio ##me ##gal ##y . no pulmonary edema . no pneumonia .
pred: 3. correct value: 2
complete opac ##ification of the right hemi thorax . no new focal consolidation within the left lung .
pred: 1. correct value: 0
no definite acute intrath ##oracic process .
pred: 1. correct value: 0
no focal consolidation . prominent bronch ##ovascular marking ##s . see accompanying ct report .
pred: 1. correct value: 0
since there are two nodular shadow ##s projecting over the right anterior fifth and sixth rib ##s , both of them cannot be nip ##ple shadow ##s . in addition , i don ' t see a corresponding shadow to either on the left . i would recommend a chest ct to evaluate presumed lung nodules . i don ' t see consolidation , pleural effusion or good evidence for central lymph node enlargement . a moderate - sized hi ##atus hernia developed between _ _ _ and _ _ _ . lateral view highlights heavy atherosclerotic calcification in the proximal great arteries and descending thoracic aorta , as well as a small volume of pleural fluid bilaterally . dr . _ _ _ was page ##d at 4 : 45 p . m . when the findings were recognized .
pred: 3. correct value: 0
no definite focal consolidation to suggest pneumonia .
pred: 1. correct value: 0
new nas ##ogastric drainage tube ends in the lower esophagus and would need to be advanced at least 12 cm to move all the side port ##s into the stomach . lungs are low in volume , exagger ##ating minimal pulmonary edema unchanged since _ _ _ _ _ _ . mild - to - moderate cardio ##me ##gal ##y and severe pulmonary artery enlargement are long ##standing . no pneumothorax . dr . _ _ _ was page ##d at 5 : 50 p . m . as soon as the findings were recognized .
pred: 3. correct value: 1
tip of the intra - aortic balloon pump is persistently at the apex of the aortic kn ##ob , 4 cm above is standard positioning . new sw ##an - gan ##z catheter ends in the right descending pulmonary artery , an should be withdrawn 2 - 3 cm to avoid inadvert ##ent wedge positioning . mild to moderate pulmonary edema has red ##istr ##ib ##uted but not but not changed in overall severity . moderately severe bib ##asi ##la ##r ate ##lec ##ta ##sis and moderate pleural effusion ##s , stable on the left , increased on the right . no pneumothorax . ind ##welling left basal pleural drainage catheter unchanged . et tube in standard placement . nas ##ogastric drainage tube passes into the stomach and out of view .
pred: 3. correct value: 0
heart size is enlarged , unchanged . mediastinal contour including promin ##ence of the main pulmonary artery . and known para - aortic lymphadenopathy are unchanged . no interval development of parenchymal abnormality is demonstrated . no new focal consolidation ##s seen . no confirmation of previously suspected lung bases abnormalities as seen on the current examination
pred: 3. correct value: 1
interval worsening of cardiopulmonary findings
pred: 1. correct value: 0
as compared _ _ _ chest radiograph , pulmonary vascular congestion and interstitial edema are new . additionally , a new poorly defined rounded opac ##ity has developed in the right mid lung as well as multifocal patchy ill - defined mid and lower lung opac ##ities bilaterally . differential diagnosis includes asymmetrical edema versus developing infectious pneumonia or multifocal aspiration . short - term followup radiographs following di ##uresis may be helpful .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices are stable . the degree of pulmonary vascular congestion has improved with continued bib ##asi ##la ##r ate ##lec ##ta ##tic changes and probable left effusion .
pred: 1. correct value: 0
heart size is enlarged . mediastin ##um is stable . patient continues to be in severe interstitial pulmonary edema associated with bilateral pleural effusion ##s , which are at least moderate , left more than right . pacemaker defibrill ##ator terminate ##s in the right ventricle .
pred: 3. correct value: 1
1 . et ##t too high , termin ##ating approximately 8 cm above the car ##ina . 2 . mild bib ##asi ##la ##r ate ##lec ##ta ##sis . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 9 : 27 am , 2 minutes after discovery of the findings .
pred: 1. correct value: 0
lung volumes are lower reflected an ate ##lec ##ta ##sis at both lung bases accompanying small pleural effusion ##s , oral , and findings after abdominal surgery . however there is greater opac ##ification in the left lower lobe between the hil ##us and the basal ate ##lec ##ta ##sis that could be pneumonia . the upper lungs are clear of consolidation . there is no pulmonary edema . heart size is normal .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study _ _ _ _ _ _ , there is little change and no evidence of acute cardiopulmonary disease . no pneumonia , vascular congestion , or pleural effusion .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has undergone abdominal surgery . a small amount of free air is seen in the abdomen . a right chest tube is in situ . no evidence of pneumothorax . no pulmonary edema . mild elongation of the descending aorta . no pleural effusion ##s .
pred: 3. correct value: 0
as compared to the previous radiograph , the monitoring and support devices are constant . the lung volumes have slightly increased , potentially reflecting improved ventilation . decrease of pulmonary fluid overload . persisting ate ##lec ##ta ##sis at the left lung bases . unchanged moderate cardio ##me ##gal ##y .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , there has been clearing of the heterogeneous opac ##ity in the right mid and upper lung . no evidence of acute pneumonia at this time . otherwise little change .
pred: 3. correct value: 0
mild interval improvement in the interstitial pulmonary edema and right - sided pleural effusion .
pred: 1. correct value: 0
stable small bilateral pleural effusion ##s .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ , 03 : 32 . the nas ##ogastric tube is now visible in its entire length . the tip projects over the pre - pylori ##c parts of the stomach . no complications , notably no pneumothorax . otherwise the radiograph is unchanged .
pred: 1. correct value: 0
no definite acute cardiopulmonary process .
pred: 1. correct value: 0
lung bases , compatible with a chronic interstitial lung disease . as findings may be slightly increased compared to the prior exam , a superimposed infectious process or exacerbation of the patient ' s underlying chronic interstitial lung disease cannot be excluded .
pred: 3. correct value: 0
no acute abnormalities identified to explain patient ' s pulmonary hypertension .
pred: 1. correct value: 0
minimal increase in size of small left effusion and adjacent ate ##lec ##ta ##sis
pred: 1. correct value: 0
component laterally . given history of blood ##y pleural fluid , this probably reflects a hem ##othorax .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
right pleural effusion drain ##ed substantially between _ _ _ and _ _ _ , subsequently unchanged , and small to moderate in volume in the right lower chest , surrounded by likely thickened ple ##ura . right lung is diffuse ##ly infiltrated , presumably with malignancy . left lung is grossly clear . heart size is normal . there is no pneumothorax . right basal pleural drain is still in place .
pred: 1. correct value: 2
left lower lobe collapse with associated effusion . no consolidation to suggest pneumonia .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
fracture is identified , this study is suboptimal for detection of rib fractures . if there is further clinical concern , dedicated rib views should be obtained .
pred: 1. correct value: 0
as compared to _ _ _ radiograph , right pig ##tail pleural catheter has slightly changed in position , with a newly appreciated tiny right apical pneumothorax . moderate right pleural effusion has also apparently slightly increased in size . persistent enlargement of cardiac sil ##hou ##ette accompanied by pulmonary vascular congestion and mild to moderate edema . small left pleural effusion is accompanied by a worsening left retro ##car ##di ##ac opac ##ity which may be due to ate ##lec ##ta ##sis and or infectious consolidation .
pred: 3. correct value: 1
pneumonia .
pred: 1. correct value: 0
effusion ##s , now essentially resolved . no acute cardiopulmonary process .
pred: 1. correct value: 0
pleural effusion ##s and mild pulmonary edema .
pred: 1. correct value: 0
low lung volumes . mild bilateral pleural effusion ##s . areas of ate ##lec ##ta ##sis at both lung bases . coexisting pneumonia cannot be excluded . no pulmonary edema . moderate cardio ##me ##gal ##y .
pred: 3. correct value: 1
1 . multifocal opac ##ities in the right base and the left mid ##lu ##ng may represent an infectious or inflammatory process . 2 . small bilateral pleural effusion ##s with adjacent ate ##lec ##ta ##sis .
pred: 3. correct value: 0
interval increase in interstitial pulmonary abnormality could be either progression of what was mild pulmonary fibrosis in _ _ _ , or the superim ##position of mild pulmonary edema . mild to moderate cardio ##me ##gal ##y is stable . mediastinal vascular dist ##ention is slightly more pronounced . aorta is generally large . no pneumothorax . pleural effusion is small if any .
pred: 3. correct value: 1
no visualized acute cardiopulmonary process .
pred: 1. correct value: 0
stre ##ak ##y retro ##car ##di ##ac opac ##ity , likely ate ##lec ##ta ##sis .
pred: 1. correct value: 0
no acute cardio ##th ##oracic process .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
central hil ##ar vascular eng ##or ##ge ##ment with mild cardio ##me ##gal ##y indicates mild pulmonary edema .
pred: 3. correct value: 1
no radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . there is severe fibros ##ing interstitial lung disease diffuse ##ly involving the hemi ##th ##ora ##ces . this makes it extremely difficult to detect superimposed pneumonia , and this diagnosis would have to be based on clinical considerations . there is evidence of a cervical fusion procedure .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to _ _ _ radiograph , a small to moderate left pleural effusion has developed with adjacent left basilar ate ##lec ##ta ##sis . no other relevant change .
pred: 1. correct value: 0
as compared to the previous radiograph , no relevant change has occurred . no pleural effusion ##s . no pneumonia , no pulmonary edema . normal size of the cardiac sil ##hou ##ette . normal hil ##ar and mediastinal contours .
pred: 1. correct value: 2
1 . no acute cardiopulmonary process . 2 . emphysema .
pred: 1. correct value: 0
1 . new right ij line , no pneumothorax . 2 . et tube tip is now 1 . 7 cm from the car ##ina . 3 . dense retro ##car ##di ##ac opac ##ity progressed over the day and likely largely due to ate ##lec ##ta ##sis potentially from mucous plug ##ging , underlying aspiration or infection are also possible .
pred: 1. correct value: 0
no focal consolidation ##s concerning for pneumonia identified .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ at 10 : 40 . the volume of the apical component of loc ##ulated right pleural effusion has decreased . the overall volume of pleural fluid and a small collection of air inferior ##ly is unchanged . right basal pig ##tail pleural drainage catheter in stable position . its relationship to the pleural loc ##ulation cannot be determined on a single frontal view . normal cardio ##medi ##astin ##al and hil ##ar sil ##hou ##ettes , left pleural surfaces , and both lungs . right pic line ends in the upper right atrium , approximately 2 cm below the expected location of the superior cav ##oa ##trial junction .
pred: 3. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
in comparison with the study _ _ _ , there has been substantial clearing of the bilateral areas of pulmonary opac ##ification . scattered areas of fibrotic change are seen , especially in the right upper zone laterally . the left hemi ##di ##aph ##ragm is now sharply seen and there is no evidence of appreciable if fusion . no acute focal pneumonia or vascular congestion at this time .
pred: 3. correct value: 0
as compared to the previous image , there is mild interval growth of a known left - sided lung mass . the extent of the minimal interstitial abnormalities on the right , associated with a mild degree of pleural thickening , are constant . moderate tort ##uo ##si ##ty of the descending aorta . mild enlargement of the left hil ##us is constant . no new nodules or masses .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
patchy bib ##asi ##la ##r air ##space opac ##ities are concerning for infection in the correct clinical setting .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there are slightly improved lung volumes . extensive ate ##lec ##ta ##tic changes are again seen at the bases with continued blunt ##ing of the cost ##oph ##ren ##ic angles suggesting small bilateral effusion ##s . in the appropriate clinical setting , it would be difficult to exclude superimposed pneumonia at 1 or both bases .
pred: 3. correct value: 0
no significant interval change in the appearance of the chest . no pulmonary metastases better evaluated on prior dedicated chest ct .
pred: 2. correct value: 0
endotracheal tube has its tip 2 . 8 cm above the car ##ina . a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip and side port projecting over the stomach . there continues to be bilateral diffuse air ##space disease which appears slightly improved suggesting a component of superimposed edema in the setting of ards or a diffuse infection . clinical correlation is advised . no pneumothorax is seen , although the sensitivity to detect pneumothorax is diminished given semi - erec ##t technique . overall cardiac and mediastinal contours are unchanged .
pred: 3. correct value: 0
lower lung volumes exagger ##ate mild cardio ##me ##gal ##y and moderate pulmonary edema . mediastinal veins are dilated , and pulmonary vasculature is indis ##tin ##ct . small pleural effusion ##s are presumed . no pneumothorax . et tube and nas ##ogastric tube are in standard positions respectively and a right central venous line ends low in the right atrium
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
low lung volumes . there is mild pulmonary edema .
pred: 1. correct value: 0
pneumonia . results were discussed with _ _ _ at 2 : 40 p . m . on _ _ _ via telephone by dr . _ _ _ at the time the findings were discovered .
pred: 1. correct value: 0
left lower lobe opac ##ification concerning for pneumonia . after several attempts to page the ordering physician _ _ _ . _ _ _ , _ _ _ decision was made to email the physician regarding the aforementioned findings by dr . _ _ _ at 16 : 15 on _ _ _ .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little change in the opac ##ification on the right , consistent with pleural effusion and volume loss in the right middle lobe and apparent collapse of the right lower lobe . on the left , there is increased opac ##ification in the mid to lower zone . this is wor ##ris ##ome for developing pneumonia . due to the overlying opac ##ifications , it is difficult to assess the degree of pulmonary edema . left subcl ##avi ##an catheter tip remains in the mid sv ##c .
pred: 3. correct value: 0
no previous images . we cardiac sil ##hou ##ette is within normal limits and there is no evidence of vascular congestion , pleural effusion , or acute focal pneumonia . no hil ##ar or mediastinal adeno ##path ##y .
pred: 3. correct value: 2
comparison to _ _ _ . no relevant change . no pneumonia . mild over ##infl ##ation . normal size of the heart . minimal bilateral apical scarring .
pred: 1. correct value: 2
lung volumes have improved . there is no pulmonary edema currently . left lower lobe consolidation is probably clearing as well . pleural effusion small on the left if any . left subcl ##avi ##an line ends low in the sv ##c . feeding tube tip is in the region of the pyl ##or ##us . no pneumothorax .
pred: 3. correct value: 0
interval placement of right - sided pic ##c line projecting over the upper portion of the sv ##c .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . elevation of left hemi ##di ##aph ##ragm with minimal associated ate ##lec ##ta ##sis . 2 . no evidence of pneumonia . 3 . mildly dist ##ended , fluid - filled stomach .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , with the chest tube on water seal , there is no evidence of pneumothorax . bib ##asi ##la ##r opac ##ifications again are consistent with ate ##lec ##ta ##tic changes bilaterally with possible left pleural effusion . there probably is mild elevation of pulmonary venous pressure .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
unchanged central pulmonary vascular congestion without evidence for pulmonary edema .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to _ _ _ , nas ##ogastric tube is been placed , termin ##ating in the proximal stomach , with side - port in close proximity to the ge junction . endotracheal tube is in standard position , and cardio ##medi ##astin ##al contours are normal . interval improvement in bib ##asi ##la ##r ate ##lec ##ta ##sis . no new foci of consolidation .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
stable right apical pneumothorax
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
lungs are well expanded and clear . heart size normal . pleural effusion minimal if any . no pneumothorax . et tube and a right internal jugular line are in standard placement ##s . nas ##ogastric tube passes into the stomach and out of view .
pred: 3. correct value: 2
in comparison with the earlier study of this date , there again is no definite pneumothorax . no appreciable increase in pleural effusion .
pred: 3. correct value: 0
chronic interstitial lung disease .
pred: 2. correct value: 0
no acute intrath ##oracic process
pred: 1. correct value: 0
1 . right internal jugular central line continues to have its tip in the right atrium . endotracheal tube has its tip approximately 4 cm above the car ##ina . a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip projecting over the stomach . biliary stent in place . low lung volumes . there has been no significant interval change in the patchy air ##space consolidation in the periphery of the right upper lung and peri ##hi ##la ##r region concerning for pneumonia . in addition , persistent retro ##car ##di ##ac opac ##ity is seen with associated small left effusion which could reflect a partial lower lobe ate ##lec ##ta ##sis , although pneumonia or aspiration is also possible . clinical correlation is advised . overall stable cardiac and mediastinal contours . scattered air in non - dist ##ended loops of predominantly small bowel . no pneumothorax .
pred: 3. correct value: 0
interval retraction of the endotracheal tube which now lies 4 . 3 cm from the car ##ina . no other significant interval change .
pred: 1. correct value: 0
in comparison to _ _ _ radiograph , to pleural catheters remain in place in the left hemi thorax , with interval increase in moderate , partially loc ##ulated left pleural effusion and adjacent worsening of ate ##lec ##ta ##sis and / or consolidation at the left lung base . no other relevant change .
pred: 3. correct value: 0
no acute traumatic abnormality identified . if there is continued concern for a rib fracture , a dedicated rib series is recommended .
pred: 2. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
yes ##ter ##day ' s mild pulmonary edema has improved . heart size is top - normal . mediastinal veins mildly dilated , as before . residual opac ##ification at the base of the right lung is probably a combination of retained edema and ate ##lec ##ta ##sis . milder ate ##lec ##ta ##sis is also present in the left mid ##lu ##ng . no pneumothorax . pleural effusion is small on the right if any .
pred: 3. correct value: 1
no evidence of pneumonia . calcified pleural plaques are likely secondary to prior asbestos exposure .
pred: 1. correct value: 0
no radiographic evidence for pneumonia . chronic interstitial abnormality , similar to the prior exam .
pred: 3. correct value: 0
intrath ##oracic process .
pred: 1. correct value: 0
1 . subtle opac ##ity in the lateral right middle lobe , which may represent early / developing pneumonia . 2 . enlargement of the pulmonary arteries bilaterally , suggesting pulmonary arterial hypertension . recommendations : three - month followup chest x - ray is recommended to it assess for resolution of suspected pneumonia and to reass ##ess the hil ##ar structures . notification : the final impression was discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 8 : 35 am , 5 minutes after discovery of the findings .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is little overall change . left chest tube remains in place and there is no evidence of a pneumothorax . persistent elevation of the right hemi ##di ##aph ##ragm with mild opac ##ification above it and is again consistent with pleural fluid and compressive ate ##lec ##ta ##sis . no evidence of acute focal pneumonia . there appears to be in mild impression on the lower right side of the cervical and upper thoracic trachea . this could reflect some thyroid enlargement .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette is within normal limits and there is no evidence of appreciable vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is no evidence of acute pneumonia , vascular congestion , pleural effusion , or parenchymal or skeletal metastasis . fixation devices seen about previous fracture of the distal left clav ##icle .
pred: 3. correct value: 0
two views are submitted . the examination marked 7 : 27 shows a nas ##ogastric tube ending at the segmental level in the right lower lobe bronchial tree . this study marked 7 : 56 shows the nas ##ogastric tube has been reposition ##ed in the low esophagus and would need to be advanced 10 cm to move all the side port ##s into the stomach . mild pulmonary edema has recurr ##ed , largely in the right lung , making it difficult to exclude concurrent pneumonia . small right pleural effusion has not changed since _ _ _ . pneum ##oper ##itoneum is decreasing . severe cardio ##me ##gal ##y and moderate - to - severe left lower lobe ate ##lec ##ta ##sis have both worsened . there is no pneumothorax . trache ##ostomy tube and right subcl ##avi ##an central venous line are in standard placement ##s , unchanged . thoracic aorta is heavily calcified throughout , but not focal ##ly dilated . dr . _ _ _ was page ##d at 9 : 18 a . m . , one minute following recognition of the radiographic findings which we discussed by telephone at 9 : 20 ##am .
pred: 3. correct value: 1
devices are in standard position . dense opac ##ification in the left retro ##car ##di ##ac region likely consolidation or ate ##lec ##ta ##sis is unchanged . confluent lung opac ##ities in the right lung , predominantly in the right lung base , which is concerning for infection has minimally increased over the last 24 hours . mildly enlarged heart size , mediastinal and hil ##ar contours are unchanged .
pred: 3. correct value: 1
in comparison to _ _ _ chest radiograph , there has not been appreciable change in the appearance of the chest .
pred: 1. correct value: 0
a nas ##ogastric tube is seen cours ##ing below the diaphragm with the tip projecting over the stomach . the patient is markedly rotated limiting evaluation of the cardiac and mediastinal contours . the aorta does appear prominent and unfolded . patchy opac ##ities at both lung bases may reflect ate ##lec ##ta ##sis , although aspiration or pneumonia should also be considered . no evidence of pulmonary edema or pneumothorax . suture material overlying the left humeral head .
pred: 3. correct value: 0
comparison _ _ _ . the patient has undergone esophag ##ectomy . all monitoring and support devices , including the 2 right - sided chest tubes , are in stable position . there is currently no evidence for the presence of pneumothorax . air collection and clips in the right chest wall . borderline size of the cardiac sil ##hou ##ette . minimal left pleural effusion and retro ##car ##di ##ac ate ##lec ##ta ##sis .
pred: 3. correct value: 1
the ng tube passes below the diaphragm termin ##ating in the stomach . rest of the tubes and lines are unchanged as well as the appearance of the lungs but there is interval improvement in the left lower lobe consolidation and persistent right basal consolidation .
pred: 3. correct value: 0
fracture on this non - dedicated exam . if desired , dedicated rib series can be performed .
pred: 3. correct value: 0
early pneumonia , recent aspiration or bronchitis .
pred: 1. correct value: 0
et tube positioned appropriately . ng tube should be advanced slightly for more optimal positioning . no acute intrath ##oracic process .
pred: 3. correct value: 0
1 . ng tube remains coiled in the esophagus . 2 . similar appearance of widespread bilateral parenchymal opac ##ities . findings were communicate ##d via phone call by dr . _ _ _ to dr . _ _ _ _ _ _ on _ _ _ at 11 : _ _ _ am .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . persistent consolidation in ling ##ula , which may be new or recurrent ate ##lec ##ta ##sis or organized pneumonia . 2 . severe bronchi ##ect ##asis and nodular opac ##ities appear stable since _ _ _ , but worse since _ _ _ . given the combination of severe bronchi ##ect ##asis and emphysema , active supp ##ura ##tive bronchi ##ect ##asis due to non - tuberc ##ulous mycobacterial infection or alpha 1 trypsin deficiency should be considered , if not already investigated . 3 . repeat chest ct upon resolution of acute symptoms is recommended for further evaluation of right paras ##pin ##al opac ##ity seen on ct from _ _ _ . 4 . displaced trachea likely from thyroid nodule seen on prior ct . recommendation ( s ) : repeat chest ct upon resolution of acute symptoms is recommended for further evaluation of right paras ##pin ##al opac ##ity seen on ct from _ _ _ . notification : the findings were discussed by dr . _ _ _ with dr . _ _ _ on the _ _ _ _ _ _ at 12 : 51 pm , 20 minutes after discovery of the findings . pertinent critical findings were post ##ed by dr . _ _ _ on _ _ _ at 20 : 40 to the department of radiology online critical communications system for direct communication to the referring provider .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . ill - defined patchy opac ##ities in lung bases which may represent areas of infection or ate ##lec ##ta ##sis . small bilateral pleural effusion ##s are present . 2 . subp ##le ##ural opac ##ity in the left lower lobe appears more prominent on the current exam , and corresponds to an area of pleural fat as noted on the prior chest ct .
pred: 3. correct value: 0
mild cardio ##me ##gal ##y stable . lungs grossly clear . minimal pulmonary vascular eng ##or ##ge ##ment stable . no edema . pleural effusion ##s are small and decreased since _ _ _ . sw ##an - gan ##z catheter tip projects over the right main pulmonary artery . right pic line can be traced as far as the mid sv ##c . trans ##ven ##ous right ventricular pace ##r lead is continuous from the left pector ##al generator .
pred: 3. correct value: 1
no radiographic evidence for acute cardiopulmonary process . no radio ##pa ##que foreign body projecting over the expected course of the esophagus .
pred: 1. correct value: 0
heart size mildly enlarged . lungs clear . normal pulmonary and mediastinal vasculature . no appreciable pleural abnormality . probable cement infusion , l1 vertebral body .
pred: 3. correct value: 1
in comparison with the earlier study of this date , there has been removal of the right chest tube with no evidence of pneumothorax . otherwise , little change .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is diffuse increase in opac ##ifications bilaterally . although some of this could represent volume overload , much of the opac ##ification , especially on the left , is consistent with superimposed pneumonia .
pred: 3. correct value: 0
there has been no interval change in relatively mild ate ##lec ##ta ##sis , right lower lobe , normal postoperative mediastin ##um following esophag ##ectomy and gastric pull - up , very small left pleural effusion . right pleural drainage tube is still in place . no appreciable pleural effusion or pneumothorax . upper enteric drainage tube ends in the lower third of the neo ##es ##ophag ##us . aside from mild left basilar ate ##lec ##ta ##sis , left lung is clear . in addition to colonic inter ##position above the liver , there may be a very small volume of pneum ##oper ##itoneum , unchanged .
pred: 3. correct value: 0
considered pneumonia until proven otherwise .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
but developing right lower lung opac ##ity suggesting pneumonia . persistent nodular focus projecting over the left mid lung and possibly a second one ; if these were confirmed to represent true pulmonary nodules rather than summation artifact and / or a nip ##ple shadow , then these might potentially represent new metastatic disease .
pred: 3. correct value: 0
in comparison to prior radiograph from earlier today , the position of the mal ##position ##ed left pic ##c is unchanged .
pred: 1. correct value: 0
small bilateral pleural effusion ##s , greater on the right , with right basilar opac ##ification concerning for infection . compressive ate ##lec ##ta ##sis is noted in the left lung base .
pred: 1. correct value: 0
evidence of pulmonary metastatic disease as seen on prior exam . findings wor ##ris ##ome for small bowel obstruction . ct scan had already been performed at time of this dict ##ation .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
moderate left pneumothorax . small bilateral pleural effusion ##s and a small collection of subcutaneous gas in the left chest wall and supra ##cl ##avi ##cu ##la ##r region , all stable . also unchanged is the relatively global but somewhat heterogeneous opac ##ification in both lungs . there is no way to exclude pneumonia as the cause of some or all of this abnormality , but the pattern of changes is also consistent with asymmetric edema , not necessarily cardio ##genic . it might be useful to evaluate the lungs with ct scanning if the problem persists after treatment for edema . right pic line ends at a level more than 8 cm below the car ##ina , would need to be withdrawn 4 cm to reposition it with confidence in the low sv ##c , if that is desired . et tube is in standard position . feeding tube ends in the stomach .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no pneum ##oper ##itoneum .
pred: 1. correct value: 0
no pneumonia . notification : the findings were discussed with _ _ _ , m . d . by _ _ _ , m . d . on the telephone on _ _ _ at 3 : 45 pm , 2 minutes after discovery of the findings .
pred: 1. correct value: 0
there has been no change since _ _ _ . component of pulmonary edema has improved since _ _ _ , but there is still substantial consolidation in both lower lungs , particularly the right where i suspect concurrent pneumonia . substantial ate ##lec ##ta ##sis is still present at the left base , and there is sufficient vascular congestion to argue for cardiac decompens ##ation . small pleural effusion ##s persist . no pneumothorax . et tube tip above the upper margin of the clav ##icles is no less than 5 cm from the car ##ina and should be advanced 2 cm for more secured seat ##ing . a left pic line ends in the mid sv ##c . no pneumothorax .
pred: 3. correct value: 0
1 . no acute cardiopulmonary process . 2 . stable flatten ##ing along the left hemi ##di ##aph ##ragm may represent a stable small left pleural effusion or elevation of left hemi ##di ##aph ##ragm , unchanged dating back to _ _ _ but new from _ _ _ . a lateral dec ##ub ##itus chest radiograph could be considered for further evaluation .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
as compared to _ _ _ , previously present asymmetrical ##ly distributed combined alveolar and interstitial opac ##ities have markedly improved with residual opac ##ities predominantly in the right peri ##hi ##la ##r region . this most likely represents asymmetrical edema . worsening opac ##ity in left retro ##car ##di ##ac region is demonstrated , likely a combination of pleural effusion and ate ##lec ##ta ##sis . small right pleural effusion is also demonstrated .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process . no significant change from the prior exam .
pred: 2. correct value: 0
since the recent study , midline drain and right chest tube have been removed , with no visible pneumothorax . moderate right pleural effusion has increased in size . stable enlargement of cardiac sil ##hou ##ette accompanied by pulmonary vascular congestion and worsening interstitial edema . left basilar ate ##lec ##ta ##sis and small pleural effusion are not appreci ##ably changed
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no change in left basal opac ##ity which likely represents known area of rounded ate ##lec ##ta ##sis in the left lower lobe with loc ##ulated small left effusion .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the cardiac sil ##hou ##ette is more prominent , though some of this may merely due relate to the portable ap rather than erec ##t pa view . similarly , there is eng ##or ##ge ##ment of the pulmonary vessels , which is consistent with some elevation of pulmonary venous pressure . no acute pneumonia or pleural effusion .
pred: 3. correct value: 1
compared to chest radiograph _ _ _ . chest radiograph on _ _ _ showed emphysema and severe pulmonary vascular congestion . mild interstitial edema may have developed . small left pleural effusion is likely . hi ##atus hernia is large . no pneumothorax . heart size top - normal .
pred: 3. correct value: 1
bib ##asi ##la ##r ate ##lec ##ta ##sis , limited exam without convincing signs of pneumonia .
pred: 1. correct value: 0
no pneumonia .
pred: 1. correct value: 0
hyper ##infl ##ation with chronic increased interstitial marking ##s , potentially due to chronic interstitial process , although interstitial edema is possible . no focal consolidation .
pred: 3. correct value: 0
persistent small left pleural effusion with compressive lower lobe ate ##lec ##ta ##sis , difficult to exclude a superimposed pneumonia . multiple displaced left rib fractures again noted .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . the monitoring and support devices are stable . mild cardio ##me ##gal ##y . mild pulmonary edema . mild retro ##car ##di ##ac ate ##lec ##ta ##sis . no focal parenchymal opac ##ities suggesting pneumonia .
pred: 3. correct value: 1
in comparison with the study _ _ _ _ _ _ , there has been a right upper lobe ##ct ##omy . no evidence of pneumothorax . substantial elevation of the right hemi ##di ##aph ##ragm ##atic contour consistent with the recent surgery . no evidence of vascular congestion or acute focal pneumonia .
pred: 3. correct value: 0
no hil ##ar mass or lymphadenopathy . no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
calcified pleural plaques compatible with prior asbestos exposure . no acute cardiopulmonary abnormality otherwise visualized .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
left internal jugular line tip is at the level of mid sv ##c . there is additional elevation of left hemi ##di ##aph ##ragm with associated ate ##lec ##ta ##sis as well as right basal opac ##ity , findings concerning for interval development of pulmonary edema .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no previous images . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
small - to - moderate bilateral pleural effusion ##s have both decreased substantially since _ _ _ and previous mild pulmonary edema has cleared . lung volumes have improved . moderate - to - severe cardio ##me ##gal ##y and a large partially fluid filled hi ##atus hernia are chronic . incidental note is made of heavy calcification of the mitral annulus , which in some patients contributes to mitral regurgitation .
pred: 3. correct value: 1
marked interval improvement in the chf findings . now only minimal residual upper zone redistribution and slight vascular bl ##urring .
pred: 1. correct value: 3
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
clear lungs with no evidence of pneumonia .
pred: 1. correct value: 0
new right pneumonia or pulmonary hemorrhage . metastatic pulmonary lesions were better evaluated on prior ct . notification : the findings were discussed with dr . _ _ _ , _ _ _ d . by _ _ _ _ _ _ , _ _ _ d . on the telephone on _ _ _ at 5 : _ _ _ pm , _ _ _ minutes after discovery of the findings .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . low lung volumes . 2 . bib ##asi ##la ##r air ##space opac ##ities likely represent ate ##lec ##ta ##sis , less likely pneumonia , depending upon the clinical circumstances 3 . minimal vascular congestion 4 . small lung nodules are better seen on prior ct consistent with metastasis
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
right lower lung consolidation concerning for pneumonia . notification : these findings were communicate ##d via telephone by dr . _ _ _ to dr . _ _ _ at _ _ _ on _ _ _ .
pred: 1. correct value: 0
endotracheal tube terminate ##s approximately 5 . 4 cm above the level of the car ##ina . enteric tube terminate ##s in the left upper quadrant , expected location of the stomach . subs ##eg ##mental left mid lung ate ##lec ##ta ##sis .
pred: 3. correct value: 0
since the recent chest radiograph from earlier today , a left pleural catheter has been removed . left lung apex is partially obscure ##d by external devices . with this limitation in mind , a small left apical pneumothorax is not appreci ##ably changed . exam is otherwise similar to the recent study except for removal of endotracheal tube and nas ##ogastric tube .
pred: 3. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality . notification : the findings were discussed with dr . _ _ _ on the telephone on _ _ _ at 3 : 27 pm .
pred: 1. correct value: 0
acute process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
findings concerning for right upper lobe pneumonia . followup radiographs are recommended after treatment to ensure resolution of this finding .
pred: 3. correct value: 0
the do ##bb ##ho ##ff feeding tube is not seen within the imaged thoracic esophagus or stomach . lungs are grossly clear . non ##obs ##truct ##ive bowel gas pattern . multiple surgical clips in the abdomen .
pred: 3. correct value: 0
as compared to the previous radiograph , pre - existing signs of mild pulmonary edema have completely resolved . there currently is no overt pulmonary edema . borderline size of the cardiac sil ##hou ##ette . the stern ##al wires are in correct alignment . valvular annulus calcifications are unchanged . no pleural effusion ##s . no pneumonia .
pred: 3. correct value: 1
as compared to the previous radiograph , there is evidence of increasing interstitial pulmonary edema that is now moderate in severity . in addition , there is a new subtle left retro ##car ##di ##ac ate ##lec ##ta ##sis . moderate cardio ##me ##gal ##y and low lung volumes persist . no larger pleural effusion ##s . no evidence of pneumonia .
pred: 3. correct value: 1
in comparison with the study of _ _ _ , the nas ##ogastric tube extends to at least the mid portion of the body of the stomach where it crosses the lower margin of the image . a view of the abdomen would be helpful to demonstrate the tip of the tube and make certain that it has not coil back on itself as on the previous study . otherwise , little change .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , there is little change in the appearance of the leads from the dual - channel pace ##r device . the overall appearance of the heart and lungs is unchanged . no evidence of pneumothorax .
pred: 3. correct value: 1
1 . no acute cardiopulmonary process . 2 . calcified nodule in the right anterior neck , most likely of thyroid etiology . if clinically indicated , recommend further evaluation with a none ##mer ##gen ##t thyroid ultrasound .
pred: 3. correct value: 0
in comparison with the study of _ _ _ , the pulmonary edema has substantially decreased . the haz ##y opac ##ification of the right hemi ##th ##orax is no longer appreciated . this could reflect substantial improvement in the pleural effusion , though some of this could merely be a manifestation of a more upright position of the patient . opac ##ification at the left base is consistent with small effusion . there are bilateral ate ##lec ##ta ##tic changes .
pred: 3. correct value: 0
over the past seven hours following removal of left apical pleural tube , there has been a substantial increase in the volume of moderate left hydro ##pn ##eu ##mo ##th ##orax . severely displaced left rib fractures noted . right lung clear . heart and mediastin ##um are normal .
pred: 3. correct value: 0
as compared to _ _ _ radiograph , postoperative appearance of cardio ##medi ##astin ##al contours is stable . improving bib ##asi ##la ##r ate ##lec ##ta ##sis and persistent small bilateral pleural effusion ##s , but no visible pneumothorax .
pred: 3. correct value: 0
no focal opac ##ity concerning for consolidation .
pred: 1. correct value: 0
mild pulmonary edema with small bilateral pleural effusion ##s and bib ##asi ##la ##r patchy opac ##ities , likely ate ##lec ##ta ##sis .
pred: 3. correct value: 0
as identified by portable chest examination .
pred: 1. correct value: 0
the patient has been intu ##ba ##ted in the meant ##ime interval with the et tube being 5 cm above the car ##inal . there is substantial interval progression in widespread parenchymal consolidation ##s representing rapidly developing infectious process with presence of bilateral air bronch ##ogram . the findings are concerning for rapidly spreading ful ##min ##ant pneumonia o potentially combination of pneumonia and ards . small bilateral pleural effusion ##s are better appreciated on the recent ct tors ##o .
pred: 3. correct value: 0
no definite acute cardiopulmonary process . bilateral lower lobe haz ##y opac ##ities / increased interstitial marking ##s are unchanged compared to _ _ _ , and again suggestive of chronic interstitial lung disease .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
increased retro ##car ##di ##ac opac ##ity , similar to _ _ _ . differential diagnosis includes ate ##lec ##ta ##sis and / or a pneumon ##ic infiltrate . small left pleural effusion is similar to the prior study . probable ate ##lec ##ta ##sis at the right base , not significantly changed . as seen on the current study , the posterior medial sixth rib fracture appears only very minimally displaced , in keeping with findings on the _ _ _ ct scan .
pred: 1. correct value: 0
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
lung volumes are unchanged following extubation . moderate right and small left pleural effusion and severe right basal ate ##lec ##ta ##sis are unchanged as is severe enlargement of the cardiac sil ##hou ##ette . no pneumothorax .
pred: 3. correct value: 1
a right chest wall biv ##entricular pacemaker defibrill ##ator has leads termin ##ating in right atrium , right ventricle , and left ventricle . the right atrial pace ##r lead appears more medial than is typically seen , however is stable from priors .
pred: 3. correct value: 0
1 . right basilar chest tube , which coils upon itself twice . 2 . resolution of right basilar ate ##lec ##ta ##sis . 3 . unchanged vascular congestion and bilateral pleural effusion ##s .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
mild to moderate pulmonary edema has increased from _ _ _ .
pred: 1. correct value: 0
some clearing in the left upper lobe component of the still severe , extensive , bilateral pulmonary consolidation . apparent decrease in opac ##ification in the right upper lobe component might be due to cavitation instead of clearing . moderate bilateral pleural effusion ##s persist . heart size normal . right pic line ends in the region of the ##su ##per ##ior cav ##oa ##trial junction . trache ##ostomy tube in standard placement . no pneumothorax . vascular stent in the right neck has not migrated .
pred: 3. correct value: 2
that limitation , no evidence of acute cardiopulmonary process . mild cardio ##me ##gal ##y . no fracture is identified .
pred: 3. correct value: 1
probable minimal bilateral pleural effusion ##s . no focal consolidation .
pred: 1. correct value: 0
significant change .
pred: 1. correct value: 0
is seen . emphysema ##to ##us changes are noted .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
right rib fractures with subcutaneous gas and a small right apical pneumothorax . right basilar opac ##ity could represent an effusion or hem ##othorax .
pred: 3. correct value: 0
cardio ##medi ##astin ##al contours are unchanged . cardiac size is top - normal . hi ##atal hernia is probably present . moderate interstitial edema has worsened . small bilateral effusion ##s larger on the left have minimally increased on the left . there is no pneumothorax . right pic ##c tip is in the mid sv ##c . the lungs are hyper ##infl ##ated . stern ##al wires are aligned , rupture of the _ _ _ stern ##al wire is again noted
pred: 3. correct value: 1
diffuse right lung opac ##ities are concerning for persistent pneumonia , which has not worsened since the radiograph on _ _ _ .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been removal of a large amount of pleural fluid from the left with no evidence of post procedure pneumothorax . the patient has taken a better inspiration . some residual opac ##ification at the left base is consistent with some combination of pleural fluid , ate ##lec ##ta ##sis , and re - expansion edema . the remainder the study is essentially unchanged .
pred: 3. correct value: 0
interstitial opac ##ities seen in prior ct are below resolution of this radiograph .
pred: 2. correct value: 0
increased small left pleural effusion and left lung base ate ##lec ##ta ##sis compared to 1 day before .
pred: 3. correct value: 0
radiographs : lungs are fully expanded and clear . there is no pleural abnormality or evidence of central adeno ##path ##y . heart size top normal . thoracic scoliosis mild with no other structural abnormality .
pred: 3. correct value: 2
in comparison with the study of _ _ _ from an outside facility , there is little change and no evidence of acute cardiopulmonary disease . the cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia .
pred: 3. correct value: 2
opac ##ity , new since prior study , additional site of metastatic disease not excluded . no evidence of acute consolidation . right base mass again seen .
pred: 3. correct value: 0
2 left - sided chest tubes in place . extensive left pneumothorax with collapse of the left lower lobe . unchanged appearance of the cardiac sil ##hou ##ette . normal appearance of the right lung . air collections in the left lateral soft tissues .
pred: 3. correct value: 1
as compared to the previous radiograph , no relevant change is seen . mild elevation of the left hemi ##di ##aph ##ragm . no pneumonia , no pulmonary edema , no pleural effusion ##s .
pred: 1. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
in comparison with the study of earlier this day , the tip of the nas ##ogastric tube now extends at least to the lower body of the stomach .
pred: 1. correct value: 0
bilaterally as compared with recent ct chest . the differential on prior ct included acute intersti ##tal pneumon ##itis , viral infection , and drug reaction . however , superimposed infection cannot be entirely excluded .
pred: 3. correct value: 0
haz ##y opac ##ity in the base of the right lung could be due to aspiration or infection .
pred: 3. correct value: 0
as compared to the previous image , the right pneumothorax has substantially increased in extent and severity . there is depression of the right hemi ##di ##aph ##ragm , indicating tension . no other change is visualized .
pred: 1. correct value: 0
pneumonia .
pred: 1. correct value: 0
small right pleural effusion with right basal ate ##lec ##ta ##sis . mild hil ##ar congestion .
pred: 1. correct value: 0
. cardiac sil ##hou ##ette is within normal limits and there is no vascular congestion , pleural effusion , or acute focal pneumonia . no evidence of old tuberc ##ulous disease .
pred: 3. correct value: 2
as compared to the previous radiograph , a retro ##car ##di ##ac ate ##lec ##ta ##sis have increased in extent . it is now accompanied by a small left basilar ate ##lec ##ta ##sis . minimal right pleural effusion persists in unchanged manner . no pneumothorax . borderline size of the cardiac sil ##hou ##ette . a right basilar ate ##lec ##ta ##sis is constant . constant air inclusion in the left - sided soft tissues .
pred: 3. correct value: 1
amount of effusion makes thorac ##ocent ##esis indicated . telephone call was placed at 4 : 40 p . m . to fa ##10 , telephone # _ _ _ . dr . _ _ _ was reached by telephone and the case was discussed . _ _ _ is likely to be performed with short notice .
pred: 1. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
the lungs remain hyper ##infl ##ated and there is bib ##asi ##la ##r ate ##lec ##ta ##sis / scarring . bilateral pulmonary opac ##ification is similar to chest radiograph from _ _ _ , a slight increase compared to _ _ _ , which could be due to infection , mild fluid overload , or other inflammatory process . no pleural effusion or pneumothorax is seen . cardiac and mediastinal sil ##hou ##ettes are stable .
pred: 1. correct value: 0
retro ##car ##di ##ac ate ##lec ##ta ##sis . no evidence of pulmonary edema .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . lung volumes remain quite low . left lower lobe has been air ##less since at least _ _ _ , presumably ate ##lec ##ta ##sis , accompanied 5 small to moderate left pleural effusion . vascular congestion has worsened in the right lung , and right basal ate ##lec ##ta ##sis is more pronounced . heart size is normal . ind ##welling cardiopulmonary support devices are in standard placement ##s .
pred: 3. correct value: 2
1 . multiple bilateral rounded pulmonary nodular densities are compatible with known advanced metastatic disease . 2 . no discrete focal consolidation concerning for pneumonia . no pneumothorax .
pred: 3. correct value: 0
1 . stable chronic pleural changes on the right . 2 . resolved opac ##ity in the right mid lung zone .
pred: 1. correct value: 0
severe cardio ##me ##gal ##y is stable . pace ##r leads are in standard position . diffuse consolidation ##s in the left lung are grossly unchanged . right peri ##hi ##la ##r opac ##ities are minimally increased . the mediastin ##um is wide ##ned and there is no pneumothorax there is no pleural effusion
pred: 3. correct value: 1
no acute cardiopulmonary abnormality .
pred: 1. correct value: 0
improved aer ##ation of the left upper and mid ##lu ##ng since the prior study . right hemi thorax is unchanged .
pred: 1. correct value: 0
in comparison to _ _ _ chest radiograph , heart is stable in size . pulmonary vascular congestion is accompanied by mild edema as well as a small right pleural effusion . asymmetrical opac ##ity at right lung base may be due to asymmetrical edema , but infectious pneumonia is also possible in the appropriate clinical setting .
pred: 1. correct value: 0
aer ##ation in the right middle and lower lobes has improved substantially . bilateral pneumonia or pulmonary edema is now more symmetric , volume of pleural fluid is difficult to assess , probably not large . heart is mildly - to - moderately enlarged . et tube in standard placement . left internal jugular line ends at the origin of the sv ##c and an upper elementary drain passes as far as the distal esophagus , but the tip cannot be located .
pred: 3. correct value: 0
right lower lobe consolidation has progressed substantially accompanied by at least a small if not moderate right pleural effusion . moderate cardiac enlargement and pulmonary vascular eng ##or ##ge ##ment suggest a component of early cardiac decompens ##ation . tracheal deviation in the neck is usually explained by left thyroid mass or nodule . dr . _ _ _ was page ##d at 11 : 30 a . m . when the findings were interpreted and we discussed the findings by telephone .
pred: 3. correct value: 1
right ij central venous catheter positioned well .
pred: 1. correct value: 0
normal chest radiograph .
pred: 1. correct value: 0
no mass or other cause for superior vena cava syndrome identified on this radiograph . chest ct is more sensitive for evaluation of superior vena cava syndrome .
pred: 3. correct value: 0
no evidence of pneumonia . emphysema
pred: 1. correct value: 0
no evidence of acute process to explain patient ' s symptoms .
pred: 1. correct value: 0
right apical pleural tube still in place . lung volumes remain quite low with substantial bib ##asi ##la ##r ate ##lec ##ta ##sis not improved . the upper lungs show less vascular eng ##or ##ge ##ment , also enc ##ase with mediastinal vessels . mild cardio ##me ##gal ##y has improved as well .
pred: 3. correct value: 1
1 . persistent tiny left apical pneumothorax without evidence of tension . 2 . persistent moderate left pleural effusion despite ple ##ur ##x catheter placement . 3 . slight interval increase in left lower lobe ate ##lec ##ta ##sis .
pred: 3. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process . event ##ra ##tion of the right hemi ##di ##aph ##ragm .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
opac ##ity which could be better defined by a none ##mer ##gen ##t ct . findings discussed with _ _ _ at 7 : 50 am on _ _ _ by _ _ _ over the phone .
pred: 1. correct value: 0
possible copd . no acute pulmonary disease .
pred: 1. correct value: 0
no focal consolidation .
pred: 1. correct value: 0
structures due to suboptimal inspiratory effort . recommend repeat examination with full inspiration .
pred: 1. correct value: 0
severe , worsening alveolar pulmonary edema . underlying infectious process cannot be ruled out .
pred: 1. correct value: 0
as compared to _ _ _ chest radiograph , cardio ##medi ##astin ##al contours are stable . worsening left retro ##car ##di ##ac opac ##ification may reflect a combination of provided history of pneumonia and accompanying ate ##lec ##ta ##sis and pleural effusion . remainder of the lungs are clear except for minimal linear ate ##lec ##ta ##sis at the right lung base .
pred: 3. correct value: 0
pulmonary vascular congestion and interstitial edema . more confluent opac ##ities at the lung bases could relate to dependent pulmonary edema , although aspiration and infectious pneumonia are additional considerations in the appropriate clinical setting . short - term followup radiographs may be helpful in this regard if warranted clinically .
pred: 1. correct value: 0
left mid ##lu ##ng opac ##ity likely represents scarring and healing of the ling ##ular lobe necrotizing pneumonia
pred: 1. correct value: 0
port - a - cath in the lower sv ##c . trace bilateral pleural effusion ##s .
pred: 2. correct value: 0
right internal jugular line tip is at the level of mid sv ##c . cardio ##me ##gal ##y is unchanged . bilateral pleural effusion ##s and bib ##asal consolidation ##s are unchanged . there is no substantial pulmonary edema ( improvement since the prior study ) .
pred: 3. correct value: 1
mild bilateral lower lobe heterogeneous opac ##ities , left greater than right , is most suggestive of ate ##lec ##ta ##sis however superimposed infection cannot be excluded .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the patient has not received a pig ##tail catheter in the left pleural space . the catheter is in correct position . the left lung is minimally better inflated than on the previous image . there is no evidence of tension . the left pneumothorax , however , is still visible and has an apical diameter of approximately 2 - 3 mm . unchanged appearance of the right lung .
pred: 3. correct value: 0
the patient carries a left - sided pic ##c line . the course of the line is unremarkable , the tip of the line projects over the mid to low sv ##c . calcified structure projecting over the mediastin ##um , likely reflecting a calcified lymph node in the aort ##opulmonary window . low lung volumes . no pneumothorax .
pred: 3. correct value: 0
opac ##ification in the right middle lobe which developed between _ _ _ and _ _ _ has not cleared . this could be ate ##lec ##ta ##sis . severe cardio ##me ##gal ##y is unchanged since _ _ _ . there is no pulmonary vascular congestion or edema . middle lobe ate ##lec ##ta ##sis , though it has failed to clear in three months , does not necessarily indicate bronchial occlusion by either a foreign body or tumor . could be ate ##lec ##ta ##tic just because of displacement by the very large right atrium . ct scanning might be able to make that distinction between the two . given the relative stability over three months , neither the right middle lobe findings nor any other in the chest is thought to represent pneumonia .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
in comparison with study of _ _ _ , there has been substantial increase in the degree of left pleural effusion in this patient with very low lung volumes . substantial volume loss in the left lower lobe and probably the ling ##ula . given the low lung volumes , there is no definite vascular congestion . of incidental note is cervical spinal fusion device .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
heart size is normal . mediastin ##um is normal . there is vascular congestion . there is no pleural effusion . there is no pneumothorax . pacemaker leads terminate in right atrium and right ventricle .
pred: 3. correct value: 2
indeterminate 3 cm ov ##oid density in the left lung base with possible retro ##car ##di ##ac correlate on lateral view . while it is possible this represents a nip ##ple shadow , either repeat radiograph with nip ##ple markers or ct examination is recommended .
pred: 3. correct value: 0
in comparison with the earlier study and of this date , the chest tube was placed on water seal . there has been a substantial increase in the amount of subcutaneous gas along the left lateral chest wall . there are several lines that could represent pleural margins indicative of pneumothorax . when the cardiac surgery unit was called , the nurse _ _ _ informed me that the house staff had reached connected the chest tube to suction .
pred: 3. correct value: 0
as compared to the previous radiograph , no relevant change is seen . the monitoring and support devices are constant . _ _ _ of small bilateral pleural effusion ##s , minimally progressive retro ##car ##di ##ac ate ##lec ##ta ##sis . mild fluid overload but no overt pulmonary edema . unchanged appearance of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . there are layer ##ing bilateral effusion ##s and bib ##asi ##la ##r air - space disease with an evolving more focal opac ##ity in the left mid lung . these findings are more concerning for aspiration and / or pneumonia rather than an asymmetric distribution of pulmonary edema given that the pulmonary vasculature appears well defined on the current examination . clinical correlation is advised . no pneumothorax . overall , cardiac and mediastinal contours are likely unchanged , although the left heart border is obscure ##d by overlying air - space process . no pneumothorax .
pred: 3. correct value: 0
1 . no focal consolidation , pleural effusion , or pneumothorax . 2 . unchanged position of the left - sided chest port , with tip termin ##ating in the right atrium .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been increase in the bilateral pulmonary opac ##ifications , consistent with moderate pulmonary edema . in the appropriate clinical setting , superimposed pneumonia cannot be excluded . basilar opac ##ifications are again consistent with small pleural effusion ##s and ate ##lec ##ta ##tic changes in this patient with stable enlargement of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
assure resolution after treatment is recommended .
pred: 1. correct value: 0
since prior exam .
pred: 1. correct value: 0
normal lung volumes . normal appearance of the mediastin ##um and the hil ##ar structures . stern ##otomy wires of the cabg show correct alignment . borderline size of the cardiac sil ##hou ##ette . mild elongation of the descending aorta . no pneumonia , no pulmonary edema . no pleural effusion ##s .
pred: 3. correct value: 1
right pic line has migrated from the right atrium to the upper sv ##c via a loop in the left brach ##io ##cephal ##ic vein . careful withdrawal of 3 . 5 cm might reduce that loop and still leave the tip in the mid sv ##c . in a similar vein , the feeding tube is loop ##ed several times in the upper stomach . previous vascular congestion has resolved . no findings of heart failure . heart is normal size . opac ##ification in the right lower chest could be either a posteriorly collected pleural effusion or severe right lower lobe ate ##lec ##ta ##sis . on the left , the appearance suggests both , but the volume of pleural fluid on each side is less today than it was on _ _ _ when the last chest radiograph was taken . dr _ _ _ _ _ _ i discussed these findings by telephone .
pred: 3. correct value: 0
ap chest compared to _ _ _ : although the right lower lobe is abnormal , its appearance has changed very little since _ _ _ and it has been a site of recurrent peri ##bronchial infiltration over the years . presence of new septal lines at the right base and persistence of those on the left suggests there may have been interc ##urrent pulmonary edema , probably resolving , since heart size is normal and mediastinal veins are not dilated . dialysis catheter ends in the right atrium . no pneumothorax or pleural effusion . overall , findings do not suggest pneumonia or even appreciable aspiration .
pred: 3. correct value: 2
no acute cardiopulmonary process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
comparison to _ _ _ . stable moderate cardio ##me ##gal ##y . decreasing lung volumes with increasing interstitial opac ##ities , notably at the right than left lung base . the changes could reflect developing pneumonia or moderate interstitial pulmonary edema . no pleural effusion ##s are present .
pred: 3. correct value: 1
no acute fractures identified . mild pulmonary vascular congestion .
pred: 1. correct value: 0
within the limitations of plain radiography , no evidence of active intrath ##oracic malignancy .
pred: 1. correct value: 0
as compared to the previous radiograph , the left chest tube was removed . small ate ##lec ##ta ##sis and minimal left pleural effusion . minimal mill ##imetric left apical pneumothorax of the tube removal . no evidence of tension . unchanged appearance of the right lung .
pred: 3. correct value: 0
no change .
pred: 1. correct value: 0
no acute cardiopulmonary process . no evidence of free air below the diaphragm .
pred: 2. correct value: 0
nas ##ogastric drainage tube has been advanced to the upper stomach , most proximal side port just beyond the gastroesophageal junction . moderate cardio ##me ##gal ##y is long ##standing . no pulmonary edema . pulmonary artery dilatation is chronic . right jugular line ends in the mid - to - low sv ##c .
pred: 3. correct value: 1
allowing for differences in technique , there has not been appreciable change in the appearance of the chest since recent study of 1 day earlier .
pred: 1. correct value: 0
the possibility of small area of new consolidation at the base of the right lung compared to have _ _ _ would be better assessed with conventional chest radiographs . there is a slightly more vascular congestion generally , but no edema or substantial pleural effusion and the heart and mediastinal veins are normal size . thickening of the minor fis ##su ##re is chronic , and linear bands of ate ##lec ##ta ##sis or scarring at the left lung base are long - standing as well .
pred: 3. correct value: 2
the patient is intu ##ba ##ted . the tip of the endotracheal tube projects approximately 4 . 5 cm above the car ##inal . the patient carries a temporal pacemaker . the patient also has a nas ##ogastric tube that shows a normal course . the tip is not included on the image . minimal fluid overload and decreased left lung volume , causing elevation of the left hemi ##di ##aph ##ragm . no larger pleural effusion ##s . a left basal pleural calcifications might be present . no pneumonia .
pred: 1. correct value: 0
no evidence of acute cardiopulmonary process .
pred: 1. correct value: 0
as compared to the previous radiograph , the lung volumes have decreased . the pre - existing left pneumothorax is no longer clearly visible . the position of the 2 left chest tubes are constant . unchanged appearance of the cardiac sil ##hou ##ette . unchanged right venous introduction sheet . unchanged size of the cardiac sil ##hou ##ette .
pred: 3. correct value: 1
no acute intrath ##oracic process .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there is been a vat ##s procedure in the left hemi ##th ##orax with expected postoperative changes . no definite evidence of pneumothorax with chest tube in place . the right lung is essentially clear .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , the monitoring and support devices have been removed . continued substantial enlargement of the cardiac sil ##hou ##ette in a patient with intact midline stern ##al wires . no definite vascular congestion . area of increased opac ##ification at the right base most likely represents stre ##aks of ate ##lec ##ta ##sis . however , in the appropriate clinical setting , superv ##ening pneumonia would have to be considered .
pred: 3. correct value: 1
intrath ##oracic process .
pred: 1. correct value: 0
interval decrease in the right pleural effusion with not visualized right pleural catheter .
pred: 1. correct value: 0
no evidence of pneumonia . new 8 mm nodular opac ##ity within the left mid lung field . this could reflect a metastasis and can be better assessed with chest ct .
pred: 3. correct value: 0
slight increase in vascular plethora
pred: 1. correct value: 0
compared to chest radiographs since _ _ _ , most recently _ _ _ . radiographic appearance of the chest has not changed since _ _ _ , including poor definition of the posterior diaphragmatic surface on the lateral view and greater radio ##den ##si ##ty projecting over the lower thoracic spine . since these are chronic findings , i do not attribute them to pneumonia . scler ##otic degenerative changes in the vertebral end ##plates are contributor ##y and the descending thoracic aorta projects over them . lungs are essentially clear . cardio ##me ##gal ##y is moderate and there is no evidence of cardiac decompens ##ation .
pred: 3. correct value: 1
no acute pulmonary disease .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
1 . no acute cardiopulmonary process . 2 . apparent dislocation of the right stern ##ocl ##avi ##cu ##la ##r joint . findings discussed with dr . _ _ _ by dr . _ _ _ at _ _ _ on _ _ _ by telephone at the time of discovery .
pred: 1. correct value: 0
new relatively extensive parenchymal opac ##ity in the retro ##car ##di ##ac lung region . accompanying blunt ##ing of the cost ##oph ##ren ##ic sinus suggesting the presence of a small pleural effusion . unchanged moderate cardio ##me ##gal ##y and elongation of the descending aorta . the right lung is unremarkable .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
no significant interval change since ct scan performed earlier the same day more clearly delineated loc ##ulated right - sided pneumothorax . other findings as above and as detailed and ct chest report
pred: 3. correct value: 0
apic ##es of both sides of the chest are excluded from the examination . a very small pneumothorax could be missed . left pleural drain , and et tube are in standard placement ##s respectively . sw ##an - gan ##z catheter tip projects over the pulmonary outflow tract . mild cardio ##me ##gal ##y is stable . right pleural effusion and right basal consolidation are clearing .
pred: 3. correct value: 1
evidence of copd . no active disease .
pred: 1. correct value: 0
in comparison with the study of _ _ _ , there has been a slight change in the appearance of the chest to , which has its tube pointing upward ##s . opac ##ification at the right base is unchanged and there is no evidence of pneumothorax . remainder of the study is little different from the previous 1 .
pred: 3. correct value: 0
a right subcl ##avi ##an infusion port ends in the mid sv ##c . there is no pneumothorax or mediastinal wide ##ning . right ##ward mediastinal shift , elevation of the right hemi ##di ##aph ##ragm and the appearance of the right infra ##hi ##la ##r lung suggests substantial lower lobe ate ##lec ##ta ##sis . ate ##lec ##ta ##sis in the left lower lung is less severe . pleural effusion ##s are small if any .
pred: 3. correct value: 0
no acute intrath ##oracic process .
pred: 1. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
chronic bony thoracic osseous changes with asymmetry of the thoracic cavities . left basilar opac ##ity could be secondary to ate ##lec ##ta ##sis given these findings although underlying effusion or consolidation is possible . additional imaging would be necessary to further assess . older exams should they become available , would be helpful .
pred: 3. correct value: 0
no acute cardiopulmonary process .
pred: 1. correct value: 0
heart size is normal . mediastin ##um is stable in appearance . lungs are clear . there is no pleural effusion or pneumothorax . note is made that the study neither confirm nor exclude the possibility of vascular abnormality such as pulmonary embolism or aortic dissection and if clinically warranted , correlation with ct angiography of the chest might be considered
pred: 3. correct value: 2
small right pleural effusion and right upper lobe consolidation , possibly representing pneumonia . recommend correlation with ct .
pred: 3. correct value: 0
stable examination of the chest .
pred: 1. correct value: 0
the comparison study _ _ _ _ _ _ , there is an placement of a nas ##ogastric tube extends well into the stomach and an endotracheal tube with its tip approximately 2 cm above the car ##ina . there is cardio ##me ##gal ##y with pulmonary edema and bilateral pleural effusion ##s with compressive ate ##lec ##ta ##sis , worse on the right .
pred: 3. correct value: 1
there is small area of consolidation in the left lung base which may be ate ##lec ##ta ##sis , however pneumonia is possible in correct clinical setting .
pred: 3. correct value: 0
slight improvement in chf with subp ##ul ##mon ##ic effusion on the right .
pred: 1. correct value: 3
compared to chest radiographs _ _ _ through _ _ _ . pulmonary edema has improved several times , most recently since _ _ _ . the current appearance of the lungs , with a severe coarse reticul ##ation may be patient ' s baseline appearance due to pulmonary fibrosis . severe cardio ##me ##gal ##y is chronic . pulmonary and mediastinal vascular eng ##or ##ge ##ment are also long - standing . pleural effusion ##s small if any . no pneumothorax . trans ##ven ##ous right atrial biv ##entricular pace ##r defibrill ##ator leads are unchanged in their respective positions .
pred: 3. correct value: 1
improved pulmonary edema and pulmonary venous congestion .
pred: 1. correct value: 0
mildly increased interstitial marking ##s at the lung bases may be due to ate ##lec ##ta ##sis .
pred: 3. correct value: 0
as compared to the previous radiograph , the lung volumes have increased . , likely reflecting improved ventilation . unchanged mild cardio ##me ##gal ##y and elongation of the descending aorta as well as left hil ##ar enlargement , caused by the known left non - small cell lung cancer , documented on the ct examination from _ _ _ . no pleural effusion ##s . no pulmonary edema . no parenchymal consolidation ##s .
pred: 3. correct value: 1
no acute cardiopulmonary process .
pred: 1. correct value: 0
markedly low lung volumes with bib ##asi ##la ##r opac ##ities which at least in part represent ate ##lec ##ta ##sis . dilated large bowel seen in the upper abdomen . recommend ct abdomen and pelvis for further evaluation .
pred: 3. correct value: 0
no acute intrath ##oracic abnormality .
pred: 1. correct value: 0
compared to chest radiographs _ _ _ through _ _ _ . although moderate cardio ##me ##gal ##y persists pulmonary vascular eng ##or ##ge ##ment has improved . no pulmonary edema . no appreciable pleural effusion . heterogeneous opac ##ification base of the left lung is new . this could be ate ##lec ##ta ##sis alone or early pneumonia . close followup advised . right jugular line ends in the low sv ##c .
pred: 3. correct value: 1
low lung volumes and left lower lobe ate ##lec ##ta ##sis .
pred: 1. correct value: 0
1 . left - sided pleural effusion . 2 . no pulmonary edema or consolidation .
pred: 3. correct value: 0