BoghdadyJR/mimicxray · Datasets at Hugging Face

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	A right pleural catheter remains in place and there is a slightly smaller but persistent apical lateral pneumothorax. Overall, there is improving aeration at the right base with decrease in size of the pleural collection. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Opacity at the left base most likely reflects partial lower lobe atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema.
	AP portable upright view of the chest. Lungs are clear though lucent and hyperinflated which likely reflect COPD. A tiny clip projects over the right upper lung. Scarring in the right lung apex appears slightly more conspicuous. No effusion or pneumothorax. No convincing evidence for pneumonia or edema. Cardiomediastinal silhouette is normal. Chronic left ribcage deformities noted.
	The chin obscures the right apex. The heart is mildly enlarged. The hilar and mediastinal contour course are unchanged. Pediatric sternal wires and a cardiac valve are unchanged in orientation. There is new pulmonary vascular congestion with mild edema and new small bilateral pleural effusions.
	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 silhouette. Unchanged right venous introduction sheet. Unchanged size of the cardiac silhouette.
	As compared to the previous radiograph, no relevant change is seen. The endotracheal tube is still high, with the tip projecting approximately 6 cm above the carinal. The tip of the nasogastric tube is at the gastroesophageal junction, the tube should be advanced by approximately 5 cm. The lung parenchyma appears unremarkable, taking into account slight patient rotation to the right. Normal size of the cardiac silhouette. No pneumothorax.
	OGT tip isin the stomach. ET tube is in standard position. The lungs are clear. Cardiomediastinal contours are normal.
	New right lower lung consolidation spans at least 3.7 cm. There is an associated right pleural effusion. The cardiomediastinal silhouette is unchanged. The tracheostomy, right IJ hemodialysis catheter, and enteric tube are unchanged in position.
	There is a right-sided PICC line with the distal lead tip in the distal SVC, appropriately sited. Heart size is within normal limits. Sodt tissue density at the GE junction is likely a hiatal hernia. Lungs are grossly clear. There is no focal consolidation or pleural effusions.
	Endotracheal tube is seen with tip approximately 6.9 cm from the carina. Enteric tube tip seen within the gastric body, side-port perhaps just past the GE junction. Right-sided central venous catheter tip projects over the lower SVC. There is no pneumothorax. Otherwise, there has been no change.
	Right PICC line tip is at the level of mid SVC. NG tube passes below the diaphragm terminating in the stomach. Cardiomediastinal silhouette is stable. Pulmonary edema is mild, unchanged.
	IN COMPARISON WITH THE EARLIER STUDY OF THIS DATE, THERE IS NO CHANGE OR EVIDENCE OF ACUTE CARDIOPULMONARY DISEASE.
	Lung volumes are low. There has been interval development of moderate to severe pulmonary edema. The heart is mildly enlarged. The azygos vein is distended. There is no large pleural effusion or pneumothorax.
	Enteric tube courses below the diaphragm, terminating in the expected location of the distal stomach/proximal duodenum. There are low lung volumes and possibly minimal vascular congestion. No definite focal consolidation is seen. No pleural effusion or pneumothorax. The cardiac silhouette is top-normal, likely accentuated by a supine, AP portable technique.
	There has been no improvement in the moderately severe interstitial abnormality throughout the left lung with greater coalescence on the right. Findings could be explained by pulmonary edema and concurrent right-sided pneumonia or even pulmonary hemorrhage. Heart is normal size and pleural effusions are small if any. The right PIC line still extends approximately 7 cm across the midline beyond the origin of the SVC. No pneumothorax.
	Moderate cardiomegaly is unchanged. Mediastinum is unchanged. The patient is intubated with the ET tube tip being 3.6 cm above the carinal. Lungs are overall clear except for minimal bibasal atelectasis. The OG tube tip is most likely in the stomach.
	New endotracheal tube in standard placement. Nasogastric tube ends in the region of the pylorus. Severe bibasilar atelectasis has not improved, but previous mild pulmonary edema has cleared. Small left pleural effusion stable. No definite pneumothorax. Heart size normal, exaggerated by low lung volumes.
	Severe cardiomegaly is stable. Mitral annulus is noted. Left pleural effusion and adjacent atelectasis have resolved. Small right effusion and adjacent atelectasis have decreased. Mild vascular congestion has improved. There is no pneumothorax. Sternal wires are aligned
	Moderate cardiomegaly a unchanged. Pleural effusions small on the right, minimal on the left if any, basal pleural drains still in place. Moderate left basal atelectasis unchanged. Left supraclavicular dialysis catheter ends in the right atrium, as before. No pneumothorax.
	The patient is status post sternotomy. A dual-lead pacemaker/ICD device, appears unchanged. The cardiac, mediastinal and hilar contours appear stable. There is similar patchy opacity at each lung base suggesting minor atelectasis or scarring. Otherwise, the lungs appear clear. Acute process is doubtful.
	Following recent right thoracentesis, a right pleural effusion has decreased in size, with residual moderate right pleural effusion, which appears partially loculated. A small lucency within the area of pleural fluid may reflect a small loculated hydropneumothorax, but there is no substantial apical pneumothorax. Cardiomediastinal contours are within normal limits. Bibasilar areas of atelectasis have slightly improved since the previous study. Small left pleural effusion is also demonstrated.
	1. Left subclavian central line continues to have its tip in the proximal to mid SVC. A nasogastric tube is seen coursing below the diaphragm with the tip coiled within the stomach. Interval removal of the endotracheal tube. Interval removal of the right internal jugular central line. Pleural and abdominal drains remain in place. Left basilar chest tube remains in place. No definite pneumothorax is seen. Interval reduction in lung volumes with crowding of the pulmonary vasculature. Areas of probable patchy atelectasis within the right lung related to the interval decrease in lung volumes. Multiple bilateral rib fractures again are seen. Overall, cardiac and mediastinal contours are likely stable given differences in positioning and inspiration.
	Single supine AP portable view of the chest was obtained. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal, likely exaggerated by supine, AP technique. No displaced fracture is identified.
	Bands of opacity in the lower lungs looks more like atelectasis than pneumonia. Upper lungs are grossly clear. Heart size is normal. There is no pleural abnormality.
	As compared to the previous radiograph, the patient has received a left pectoral ICD. The course of the leads is unremarkable, the tip of the leads project over the right ventricle. Pre-existing sternal wires and clips after bypass surgery are in unchanged position. Unchanged moderate cardiomegaly without pulmonary edema. No evidence of pneumothorax. No larger pleural effusions.
	Right PICC line tip not well seen. Enteric tube tip below diaphragm. Shallow inspiration. Bibasilar opacities, likely atelectasis, similar to prior. Mild interstitial prominence in the lower lungs, may represent edema, similar. Shallow inspiration accentuates heart size, pulmonary vascularity. Probable small right pleural effusion, similar. No pneumothorax. Chronic fracture right clavicle.
	Compared to the prior study, the lung volumes are slightly lower and there is volume loss in both lower lungs. There is ill definition of the left hemidiaphragm and it is unclear if there is a small infiltrate in this region. There is a new small left pleural effusion. The heart size continues to be moderately enlarged. The dual-lead pacemaker is unchanged. There is mild pulmonary vascular redistribution.
	Allowing for lower lung volumes, which accentuate the cardiac silhouette and bronchovascular structures, there has probably not been a substantial short interval relevant change in the appearance of the chest since the recent study of one day earlier. However, a repeat radiograph at a similar lung volume to the prior radiograph may be considered for more accurate comparison if the patient's clinical status has changed in the last 24 hours.
	There are new bilateral parenchymal opacities most notably at the right lung base and left mid lung. There is no large effusion or visualized pneumothorax. The cardiomediastinal silhouette is within normal limits for technique and low inspiratory effort. Spinal stimulator leads are noted.
	As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. Borderline size of the cardiac silhouette, bilateral pleural effusions that might have slightly increased. Subsequent areas of atelectasis bilaterally. No newly appeared focal parenchymal opacities. No pneumothorax.
	A newly placed feeding tube is coiled in the pharynx. The tube does not reach the esophagus. Tube reposition is required.
	ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Bibasal consolidations appear to be unchanged since the prior study
	The lung volumes are low with minimal increase of mild atelectasis at left base. There is no lung opacity worrisome for pneumonia. Cardiac contour is top normal. There is no pleural effusion or pneumothorax.
	A Y stent is seen in place. The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. Four metallic densities are seen projected over the upper chest and may represent piercings.
	No evidence of pneumothorax is present. Right basal opacity is expected. Cardiomediastinal silhouette is stable.
	When compared to prior study performed seven hours earlier, there has been interval increase in left lower lobe opacity consistent with increasing pleural effusion and adjacent consolidation. Right lower lobe atelectasis is stable. There are lower lung volumes that limit the evaluation of this study. Cardiac size cannot be evaluated , is obscured by the pleural parenchymal abnormalities. Widened mediastinum is unchanged. The small left pneumothorax is unchanged allowing for the difference in positioning of the patient.
	Left chest wall pacing leads again terminating in the right atrium and right ventricle. The lungs are normally expanded and clear. Severe cardiomegaly is unchanged. There is no pleural effusion or pneumothorax. There is no pulmonary edema. Moderate degenerate changes are again seen throughout the right glenohumeral joint.
	There has been placement of an NG tube with the tip terminating well into the distal stomach. There is poor inspiratory effort, which accentuates prominence of the heart and vascular structures. There is bibasilar atelectasis and small effusions. There is no pneumothorax.
	Since the chest radiograph obtained 2 days prior, no significant changes are appreciated. Mild cardiomegaly and moderate pulmonary edema are unchanged. New, small, right pleural effusion. Lungs are otherwise fully expanded without focal consolidation.
	1. Interval recurrence of relatively large pneumothorax at the right lung, predominantly at the right lung base, after chest tube placed on waterseal. 2. Left lung largely unchanged, but note is made of possible slight interval leftward shift of the mediastinum. Clinical correlation and attention to this area on followup films is requested.
	The upper enteric drainage tube ends in the mid portion of a much less distended stomach. The lungs are clear. Cardiomediastinal and hilar contours are stable. Mild to moderate thoracolumbar scoliosis is probably chronic.
	The endotracheal tube ends 3.2 cm above the level of the carina. A right internal jugular central venous catheter ends in the mid-to-low SVC, unchanged. An enteric catheter courses below the level of the diaphragm, curving superiorly to end in the gastric cardia. A Dobbhoff tube also passes below the level of the diaphragm and out of the field of view inferiorly. An additional tube/wire projects over the right cervical region, possibly external to the patient, unchanged. Widespread bilateral interstitial opacities are minimally increased, particularly within the right mid lung. Bibasilar left greater than right heterogeneous opacities are likely atelectasis. There are no definite pleural effusions. No pneumothorax is seen. The heart size is top normal, unchanged. The mediastinal contours are normal.
	Portable AP chest radiograph. The lungs are hyperexpanded. Blunting of the bilateral costophrenic sulci may represent either small pleural effusions or pleural thickening. There is no evidence of pulmonary edema. The heart size is normal. There is no pneumothorax.
	Comparison is made to the prior study performed a day earlier. Cardiac size is normal. The aorta is tortuous. Large bilateral pleural effusions with associated atelectasis and pulmonary edema are unchanged. Lines and tubes are in standard position.
	Frontal chest radiograph. Supine positioning accentuates moderate cardiomegaly as well as vascular congestion which with mediastinal venous dilatation is more pronounced over three hours probably due to volume administration. Small right and moderate left pleural effusions have increased, but there is no pulmonary edema. Bibasilar opacities consistent with effusions and atelectasis. No pneumothorax. Rib fractures better seen on concurrent CT.
	No previous images. The heart is normal size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Streaks of atelectasis are seen at both bases.
	Right PICC line tip is in the L level of mid to lower SVC. The up of tube passes below the diaphragm most likely terminating in the stomach. No change in the mild cardiomegaly and mediastinal contour demonstrated. Patient continues to be in severe pulmonary edema. Underlying infection, although possibility, is less likely all might contribute to certain extent to the above described abnormalities.
	In comparison with the earlier study of this date, the tip of the endotracheal tube measures approximately 3.2 cm above the carina. Little overall change in the appearance of the heart and lungs.
	A single portable AP chest radiograph was obtained. Lung volumes are low. The lungs are clear. There is no focal consolidation, effusion or pneumothorax. Heart size is still normal, but azygous and mediastinal veins are mildly dilated, perhaps an indication of right heart dysfunction or other cause of elevated central venous pressure. Clinical correlation would be wise.
	Right PICC line tip is in the right atrium and should be pulled back approximately 3 cm. There is interval resolution of pulmonary edema. There is also interval improvement of bilateral pleural effusions. No pneumothorax is seen.
	Radiograph obtained centered at the thoracoabdominal junction was performed for assessment of a nasogastric tube, which terminates within the distal stomach. Heart size is normal, and lungs are clear except for focal linear atelectasis at the lung bases.
	Frontal view of the chest was obtained. The heart is normal size. Increased retrocardiac opacity is compatible with known left hilar mass and left lower lobe collapse. Left main stem bronchus stent is in similar position to prior. The right lung is grossly clear, with known nodules better appreciated on CT. No pneumothorax.
	The enteric tube and right-sided PICC line appear unchanged position. There is unchanged cardiomegaly and mediastinal prominence. There is persistent prominence of the pulmonary interstitial markings likely due to fluid overload. More focal area of consolidation within the right base is again seen. There are no pneumothoraces. Overall, these findings are relatively stable.
	No significant change. There remains possibility of a small right upper lobe nodule. No acute pneumonia.
	There has been interval decrease in the amount of vascular plethora. The heart continues to be mildly enlarged. There small bilateral effusions. There is volume loss at the bases.
	The patient carries an endotracheal tube. The tip of the tube projects 0.7 cm above the carina. There is a nasogastric tube in situ. The tip projects over the middle part of the stomach. A second tube appears to be outside of the patient. Additional abdominal drains. Low lung volumes. Extensive areas of atelectasis and mild overhydration. No pleural effusions. Borderline size of the cardiac silhouette.
	The left-sided PICC line has not changed since the previous exam. It is radiographically at the level of the lower portion of the superior vena cava. Stability of the low lung volumes and bilateral interstitial markings in this patient with known interstitial lung disease. There is no pneumothorax. There are no pleural effusion and no pneumothorax.
	There are persistent low lung volumes. Cardiomegaly cannot be assessed. Large right pleural effusion has increased. Underlying consolidation appears to be increased. Moderate pulmonary edema is stable. There is no evident pneumothorax.
	As compared to the previous radiograph, there is no relevant change. Right-sided pleural catheter is in situ. No evidence of pneumothorax. The remaining right pleural effusion and the areas of atelectasis are without substantial change. No evidence of pneumothorax. Moderate cardiomegaly. Normal appearance of the left lung.
	Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. The right lung is clear. Stable-appearing small left-sided pleural effusion with adjacent atelectasis. Small amount of subcutaneous emphysema along the left chest wall. Persistent moderate cardiomegaly. Three chest tubes project over the left hemithorax.
	Mediastinal contours are unremarkable. Dense airspace opacities are present in the lower lungs bilaterally, right more than left. Peribronchial cuffing is noted. A small bilateral pleural effusions very present.
	Since the chest radiograph obtained 5 days prior, there is been interval removal of a right-sided IJ central venous catheter and improvement in retrocardiac atelectasis. There is unchanged hyperinflation. The lungs are otherwise clear without focal consolidation or pulmonary nodules. The cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal.
	A moderate-to-large right pneumothorax persists. There has been interval decrease in size of its basilar component. The apical component remains essentially unchanged. Chest tubes are in unchanged position. Cardiomediastinal contours are normal. Left lung is clear.
	AP upright portable chest radiograph provided. No large consolidation, effusion, or pneumothorax is seen. The heart appears normal in size. The mediastinal contour appears normal. There is a dextroscoliosis of the T-spine. Bony structures are demineralized, though appear intact.
	Left PICC line tip is at the level of mid SVC. Right internal jugular line tip is at the level of superior SVC. Bibasal consolidations and bilateral pleural effusions are overall unchanged. No new pneumothorax.
	Endotracheal tube tip terminates 3.9 cm from the carina. Orogastric tube tip is within the stomach as is the side port. Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of cardiac silhouette is seen. Calcifications are noted within the AP window, likely within lymph nodes. Moderate pulmonary edema is demonstrated. No large pleural effusion or pneumothorax is present. Clips are noted in the right upper quadrant of the abdomen. There is no pneumothorax.
	As compared to the previous radiograph, the pre described right apical tiny pneumothorax is no longer seen. The pre-existing opacities, both at the level of the right upper lobe and right perihilar as well as left perihilar areas have completely resolved. The retrocardiac atelectasis has improved and is now minimal. No new opacities. No pleural effusions. Normal size of the cardiac silhouette.
	In comparison with the study of earlier in this date, the right chest tube has been removed and there is no evidence of pneumothorax. The remainder the study is essentially unchanged.
	Since prior, left pleural effusion has slightly decreased in size. The lungs are grossly clear. Cardiomediastinal silhouette is unchanged. Small right pleural has resolved. There is no pneumothorax.
	A single portable AP upright view of the chest was obtained. Heart is normal size and cardiomediastinal contour is notable for calcifications in the aortic arch. Hyperinflated and hyperlucent lungs are suggestive of emphysema. There is no consolidation, pleural effusion or pneumothorax.
	Extensive nodular densities project over the lungs bilaterally consistent with pleural plaques secondary to prior asbestos exposure. Interval improvement of previously seen pulmonary vascular congestion and trace pulmonary edema stable right pleural effusion. With this improvement previously seen left mid lung airspace opacification since consistent with known pleural plaques.
	The lung volumes are low. Mild fluid overload but no overt pulmonary edema. Mild cardiomegaly. No pleural effusions. No pneumonia, no pneumothorax.
	The left internal jugular venous catheter line has been removed in the interim. A left subclavian approach PICC tip has been retracted in the interim and now projects over expected region of the cavoatrial junction. Lung volumes are low with bronchovascular crowding. Linear bandlike opacity projecting over the left mid lung is probably platelike atelectasis and/or scarring, seen on the prior exam and unchanged. No pleural effusion, pneumothorax, or frank pulmonary edema. No definite focal consolidation.
	NG tube tip isin the stomach. Bibasilar atelectasis have markedly increased on the right. There is no evident pneumothorax or enlarging effusions. Cardiomegaly is stable. Stent in the right upper quadrant is again noted.
	The patient remains intubated. An endotracheal tube terminates approximately 3 cm above the carina. An orogastric tube courses into the stomach. The right hemidiaphragm is now somewhat obscured with new vague opacification projecting over the right lower lung but sparing the right cardiac border. Elsewhere, the lungs remain clear. There is no definite pleural effusion. There is no pneumothorax.
	A skin fold projecting over the left lateral chest should not be mistaken for pneumothorax. Moderate cardiomegaly is accompanied by pulmonary vascular congestion and possibly mild pulmonary edema. Heterogeneous appearance of the lower lungs particularly the right could be due to chronic lung disease, but would make it difficult to detect early pneumonia. There is no pneumonia in the upper lungs. Small right pleural effusion is likely.
	Single frontal view of the chest was obtained. Free air is present underneath both hemidiaphragms. Lung volumes are low. The vascular pedicle is widened and there is slightly increased rightward shift of the trachea, which may be projectional. Multi focal ill-defined lung opacities are similar to prior and consistent with history of sarcoidosis although superimposed infection cannot be excluded. No pneumothorax or substantial pleural effusion. Chain sutures in the right mid lung are similar to prior.
	AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained seven hours earlier during the same day. The AP single radiograph demonstrates unchanged position of the previously described small caliber pigtail ending pleural drainage catheter. There is no evidence of any remaining apical pneumothorax. However, hazy density occupying the entire left side hemithorax and elevated diaphragm is suggestive of pleural effusions layering in the posterior pleural spaces. The right hemithorax is unremarkable as before.
	Feeding tube has been repositioned, now ending in the region of the pylorus. Lung volumes are low but no focal pulmonary abnormality is seen. Heart size probably normal. No pneumothorax or significant pleural effusion. Right pic line ends in the low SVC.
	1. Nasogastric tube remains unchanged in position. Right chest tube also remains in place, unchanged. A left subclavian central line has its tip in the distal SVC, unchanged. There continues to be a small left effusion with associated air space opacity most likely representing compressive atelectasis. Bibasilar opacity is also again seen likely representing a combination of postoperative changes and atelectasis. No evidence of pulmonary edema. No pneumothorax. Stable cardiac and mediastinal contours.
	Compared to the prior study there is no significant interval change.Trace left pleural effusion versus basilar atelectasis. Otherwise, grossly clear lungs bilaterally
	As compared to the prior examination, there has been no significant interval change. The patient is status post VATS right hilar nodal biopsy, and there is no overt pneumothorax identified. A right chest tube is in unchanged location. Small, bilateral pleural effusions are unchanged. Allowing for differences in the patient positioning, the cardiomediastinal silhouette is unchanged.
	An endotracheal tube is in place terminating 2.7 cm above the carina. The cardiomediastinal and hilar contours are within normal limits. There are several small foci of peripheral opacity within the right mid and lower lung, concerning for infection or aspiration. The left lung is clear. There is no pleural effusion or pneumothorax.
	1. Endotracheal tube now has its tip 3.7 cm above the carina. Right internal jugular central line has its tip in the proximal SVC. Nasogastric tube courses below diaphragm with tip not identified. The lung volumes remain low with persistent retrocardiac opacity and probable layering effusion consistent with compressive atelectasis. Pneumonia cannot be entirely excluded. There is also likely patchy atelectasis at the right medial lung base. No pulmonary edema or pneumothorax. Overall, cardiac and mediastinal contour is stable given differences in patient rotation.
	As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are constant. Constant appearance of cervical fixation devices. Moderate cardiomegaly, known post-procedure parenchymal opacities on the right and atelectasis at the left lung bases.
	In comparison with the earlier study of this date, the patient has taken a slightly better inspiration. The right subclavian catheter extends to the cavoatrial junction or upper portion of the right atrium. Nasogastric tube extends to the second portion of the duodenum. Opacification at the left base is again consistent with substantial volume loss in the left lower lobe and pleural effusion. Less prominent atelectatic changes are seen at the right base. The pulmonary vascularity is probably within normal limits given the low lung volumes, which accentuate the transverse diameter of the heart.
	There is diffuse hazy opacification of the lungs, compatible with edema. There are suspected small bilateral pleural effusions. No pneumothorax is seen. No definite consolidation to suggest pneumonia is seen. There is mild cardiomegaly.
	Single supine portable view of the chest. No prior. Lung volumes are low though lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
	There is a nasogastric tube which terminates in the gastric fundus. The cardiac, mediastinal and hilar contours appear unchanged. The heart is probably at the upper limits of normal size. The aortic arch is partly calcified. Lung volumes are somewhat low. The lungs appear clear. There is no pleural effusion or pneumothorax. No free air is seen.
	Single portable view of the chest. Low lung volumes are noted. Within limitation of overlying trauma board, the lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No displaced fractures are identified.
	AP portable upright view of the chest. Surgical hardware is seen in the cervical spine and right shoulder. A right IJ central venous catheter is again seen with its tip in the region of the low SVC. The lungs are clear bilaterally. There is no pneumothorax. Heart size is mildly enlarged and stable. Mediastinal contour is unremarkable. The bony structures appear intact. Scoliosis partially visualized in the upper lumbar spine.
	As compared to the previous image, the nasogastric tube has been advanced. The patient is now intubated. The tip of the endotracheal tube projects 3.8 cm above the carina. No pleural effusions. No pneumonia. No pulmonary edema.
	One portable supine AP view of the chest. Right internal jugular catheter tip is in the right atrium. Left PICC line ends at the cavoatrial junction. Tracheostomy tube ends 3 cm from the carina. Bibasilar atelectasis and small left pleural effusion are unchanged. No focal parenchymal opacity is concerning for pneumonia. Cardiac, mediastinal, and hilar contours are stable.
	Support lines and tubes including right-sided pacemaker are unchanged in position. There is cardiomegaly which is stable. There is a persistent left retrocardiac opacity and left-sided pleural effusion, unchanged. There are no signs for overt pulmonary edema or pneumothoraces.
	Compared to the prior study there is no significant interval change.
	In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the upper stomach. However, the sidehole is above the level of the esophagogastric junction and the tube should be pushed forward at least 6 cm. Little change in the appearance of the heart and lungs.
	No previous images. Cardiac silhouette is within normal limits and there is no evidence of vascular congestion or pleural effusion. Minimal atelectatic streaks above a slightly elevated left hemidiaphragm. No acute pneumonia.
	In comparison with the earlier study of this date, the left chest tube has been removed. No convincing evidence of pneumothorax. Otherwise, little change from the earlier study of this date.
	As compared to the previous radiograph, the lungs have increased in transparency and the signs indicative of pulmonary edema have decreased in severity. No new focal parenchymal opacities. No pleural effusions. Unchanged elevation of the right hemidiaphragm. Unchanged moderate cardiomegaly.
	A small left-sided pneumothorax is probably unchanged. There has been no significant short-term change.
	Allowing for differences in technique, there has not been a relevant change in the appearance of the chest since the recent radiograph of 1 day earlier.

A right pleural catheter remains in place and there is a slightly smaller but persistent apical lateral pneumothorax. Overall, there is improving aeration at the right base with decrease in size of the pleural collection. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Opacity at the left base most likely reflects partial lower lobe atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema.

AP portable upright view of the chest. Lungs are clear though lucent and hyperinflated which likely reflect COPD. A tiny clip projects over the right upper lung. Scarring in the right lung apex appears slightly more conspicuous. No effusion or pneumothorax. No convincing evidence for pneumonia or edema. Cardiomediastinal silhouette is normal. Chronic left ribcage deformities noted.

The chin obscures the right apex. The heart is mildly enlarged. The hilar and mediastinal contour course are unchanged. Pediatric sternal wires and a cardiac valve are unchanged in orientation. There is new pulmonary vascular congestion with mild edema and new small bilateral pleural effusions.

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 silhouette. Unchanged right venous introduction sheet. Unchanged size of the cardiac silhouette.

As compared to the previous radiograph, no relevant change is seen. The endotracheal tube is still high, with the tip projecting approximately 6 cm above the carinal. The tip of the nasogastric tube is at the gastroesophageal junction, the tube should be advanced by approximately 5 cm. The lung parenchyma appears unremarkable, taking into account slight patient rotation to the right. Normal size of the cardiac silhouette. No pneumothorax.

OGT tip isin the stomach. ET tube is in standard position. The lungs are clear. Cardiomediastinal contours are normal.

New right lower lung consolidation spans at least 3.7 cm. There is an associated right pleural effusion. The cardiomediastinal silhouette is unchanged. The tracheostomy, right IJ hemodialysis catheter, and enteric tube are unchanged in position.

There is a right-sided PICC line with the distal lead tip in the distal SVC, appropriately sited. Heart size is within normal limits. Sodt tissue density at the GE junction is likely a hiatal hernia. Lungs are grossly clear. There is no focal consolidation or pleural effusions.

Endotracheal tube is seen with tip approximately 6.9 cm from the carina. Enteric tube tip seen within the gastric body, side-port perhaps just past the GE junction. Right-sided central venous catheter tip projects over the lower SVC. There is no pneumothorax. Otherwise, there has been no change.

Right PICC line tip is at the level of mid SVC. NG tube passes below the diaphragm terminating in the stomach. Cardiomediastinal silhouette is stable. Pulmonary edema is mild, unchanged.

IN COMPARISON WITH THE EARLIER STUDY OF THIS DATE, THERE IS NO CHANGE OR EVIDENCE OF ACUTE CARDIOPULMONARY DISEASE.

Lung volumes are low. There has been interval development of moderate to severe pulmonary edema. The heart is mildly enlarged. The azygos vein is distended. There is no large pleural effusion or pneumothorax.

Enteric tube courses below the diaphragm, terminating in the expected location of the distal stomach/proximal duodenum. There are low lung volumes and possibly minimal vascular congestion. No definite focal consolidation is seen. No pleural effusion or pneumothorax. The cardiac silhouette is top-normal, likely accentuated by a supine, AP portable technique.

There has been no improvement in the moderately severe interstitial abnormality throughout the left lung with greater coalescence on the right. Findings could be explained by pulmonary edema and concurrent right-sided pneumonia or even pulmonary hemorrhage. Heart is normal size and pleural effusions are small if any. The right PIC line still extends approximately 7 cm across the midline beyond the origin of the SVC. No pneumothorax.

Moderate cardiomegaly is unchanged. Mediastinum is unchanged. The patient is intubated with the ET tube tip being 3.6 cm above the carinal. Lungs are overall clear except for minimal bibasal atelectasis. The OG tube tip is most likely in the stomach.

New endotracheal tube in standard placement. Nasogastric tube ends in the region of the pylorus. Severe bibasilar atelectasis has not improved, but previous mild pulmonary edema has cleared. Small left pleural effusion stable. No definite pneumothorax. Heart size normal, exaggerated by low lung volumes.

Severe cardiomegaly is stable. Mitral annulus is noted. Left pleural effusion and adjacent atelectasis have resolved. Small right effusion and adjacent atelectasis have decreased. Mild vascular congestion has improved. There is no pneumothorax. Sternal wires are aligned

Moderate cardiomegaly a unchanged. Pleural effusions small on the right, minimal on the left if any, basal pleural drains still in place. Moderate left basal atelectasis unchanged. Left supraclavicular dialysis catheter ends in the right atrium, as before. No pneumothorax.

The patient is status post sternotomy. A dual-lead pacemaker/ICD device, appears unchanged. The cardiac, mediastinal and hilar contours appear stable. There is similar patchy opacity at each lung base suggesting minor atelectasis or scarring. Otherwise, the lungs appear clear. Acute process is doubtful.

Following recent right thoracentesis, a right pleural effusion has decreased in size, with residual moderate right pleural effusion, which appears partially loculated. A small lucency within the area of pleural fluid may reflect a small loculated hydropneumothorax, but there is no substantial apical pneumothorax. Cardiomediastinal contours are within normal limits. Bibasilar areas of atelectasis have slightly improved since the previous study. Small left pleural effusion is also demonstrated.

1. Left subclavian central line continues to have its tip in the proximal to mid SVC. A nasogastric tube is seen coursing below the diaphragm with the tip coiled within the stomach. Interval removal of the endotracheal tube. Interval removal of the right internal jugular central line. Pleural and abdominal drains remain in place. Left basilar chest tube remains in place. No definite pneumothorax is seen. Interval reduction in lung volumes with crowding of the pulmonary vasculature. Areas of probable patchy atelectasis within the right lung related to the interval decrease in lung volumes. Multiple bilateral rib fractures again are seen. Overall, cardiac and mediastinal contours are likely stable given differences in positioning and inspiration.

Single supine AP portable view of the chest was obtained. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal, likely exaggerated by supine, AP technique. No displaced fracture is identified.

Bands of opacity in the lower lungs looks more like atelectasis than pneumonia. Upper lungs are grossly clear. Heart size is normal. There is no pleural abnormality.

As compared to the previous radiograph, the patient has received a left pectoral ICD. The course of the leads is unremarkable, the tip of the leads project over the right ventricle. Pre-existing sternal wires and clips after bypass surgery are in unchanged position. Unchanged moderate cardiomegaly without pulmonary edema. No evidence of pneumothorax. No larger pleural effusions.

Right PICC line tip not well seen. Enteric tube tip below diaphragm. Shallow inspiration. Bibasilar opacities, likely atelectasis, similar to prior. Mild interstitial prominence in the lower lungs, may represent edema, similar. Shallow inspiration accentuates heart size, pulmonary vascularity. Probable small right pleural effusion, similar. No pneumothorax. Chronic fracture right clavicle.

Compared to the prior study, the lung volumes are slightly lower and there is volume loss in both lower lungs. There is ill definition of the left hemidiaphragm and it is unclear if there is a small infiltrate in this region. There is a new small left pleural effusion. The heart size continues to be moderately enlarged. The dual-lead pacemaker is unchanged. There is mild pulmonary vascular redistribution.

Allowing for lower lung volumes, which accentuate the cardiac silhouette and bronchovascular structures, there has probably not been a substantial short interval relevant change in the appearance of the chest since the recent study of one day earlier. However, a repeat radiograph at a similar lung volume to the prior radiograph may be considered for more accurate comparison if the patient's clinical status has changed in the last 24 hours.

There are new bilateral parenchymal opacities most notably at the right lung base and left mid lung. There is no large effusion or visualized pneumothorax. The cardiomediastinal silhouette is within normal limits for technique and low inspiratory effort. Spinal stimulator leads are noted.

As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant. Borderline size of the cardiac silhouette, bilateral pleural effusions that might have slightly increased. Subsequent areas of atelectasis bilaterally. No newly appeared focal parenchymal opacities. No pneumothorax.

A newly placed feeding tube is coiled in the pharynx. The tube does not reach the esophagus. Tube reposition is required.

ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Bibasal consolidations appear to be unchanged since the prior study

The lung volumes are low with minimal increase of mild atelectasis at left base. There is no lung opacity worrisome for pneumonia. Cardiac contour is top normal. There is no pleural effusion or pneumothorax.

A Y stent is seen in place. The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. Four metallic densities are seen projected over the upper chest and may represent piercings.

No evidence of pneumothorax is present. Right basal opacity is expected. Cardiomediastinal silhouette is stable.

When compared to prior study performed seven hours earlier, there has been interval increase in left lower lobe opacity consistent with increasing pleural effusion and adjacent consolidation. Right lower lobe atelectasis is stable. There are lower lung volumes that limit the evaluation of this study. Cardiac size cannot be evaluated , is obscured by the pleural parenchymal abnormalities. Widened mediastinum is unchanged. The small left pneumothorax is unchanged allowing for the difference in positioning of the patient.

Left chest wall pacing leads again terminating in the right atrium and right ventricle. The lungs are normally expanded and clear. Severe cardiomegaly is unchanged. There is no pleural effusion or pneumothorax. There is no pulmonary edema. Moderate degenerate changes are again seen throughout the right glenohumeral joint.

There has been placement of an NG tube with the tip terminating well into the distal stomach. There is poor inspiratory effort, which accentuates prominence of the heart and vascular structures. There is bibasilar atelectasis and small effusions. There is no pneumothorax.

Since the chest radiograph obtained 2 days prior, no significant changes are appreciated. Mild cardiomegaly and moderate pulmonary edema are unchanged. New, small, right pleural effusion. Lungs are otherwise fully expanded without focal consolidation.

1. Interval recurrence of relatively large pneumothorax at the right lung, predominantly at the right lung base, after chest tube placed on waterseal. 2. Left lung largely unchanged, but note is made of possible slight interval leftward shift of the mediastinum. Clinical correlation and attention to this area on followup films is requested.

The upper enteric drainage tube ends in the mid portion of a much less distended stomach. The lungs are clear. Cardiomediastinal and hilar contours are stable. Mild to moderate thoracolumbar scoliosis is probably chronic.

The endotracheal tube ends 3.2 cm above the level of the carina. A right internal jugular central venous catheter ends in the mid-to-low SVC, unchanged. An enteric catheter courses below the level of the diaphragm, curving superiorly to end in the gastric cardia. A Dobbhoff tube also passes below the level of the diaphragm and out of the field of view inferiorly. An additional tube/wire projects over the right cervical region, possibly external to the patient, unchanged. Widespread bilateral interstitial opacities are minimally increased, particularly within the right mid lung. Bibasilar left greater than right heterogeneous opacities are likely atelectasis. There are no definite pleural effusions. No pneumothorax is seen. The heart size is top normal, unchanged. The mediastinal contours are normal.

Portable AP chest radiograph. The lungs are hyperexpanded. Blunting of the bilateral costophrenic sulci may represent either small pleural effusions or pleural thickening. There is no evidence of pulmonary edema. The heart size is normal. There is no pneumothorax.

Comparison is made to the prior study performed a day earlier. Cardiac size is normal. The aorta is tortuous. Large bilateral pleural effusions with associated atelectasis and pulmonary edema are unchanged. Lines and tubes are in standard position.

Frontal chest radiograph. Supine positioning accentuates moderate cardiomegaly as well as vascular congestion which with mediastinal venous dilatation is more pronounced over three hours probably due to volume administration. Small right and moderate left pleural effusions have increased, but there is no pulmonary edema. Bibasilar opacities consistent with effusions and atelectasis. No pneumothorax. Rib fractures better seen on concurrent CT.

No previous images. The heart is normal size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Streaks of atelectasis are seen at both bases.

Right PICC line tip is in the L level of mid to lower SVC. The up of tube passes below the diaphragm most likely terminating in the stomach. No change in the mild cardiomegaly and mediastinal contour demonstrated. Patient continues to be in severe pulmonary edema. Underlying infection, although possibility, is less likely all might contribute to certain extent to the above described abnormalities.

In comparison with the earlier study of this date, the tip of the endotracheal tube measures approximately 3.2 cm above the carina. Little overall change in the appearance of the heart and lungs.

A single portable AP chest radiograph was obtained. Lung volumes are low. The lungs are clear. There is no focal consolidation, effusion or pneumothorax. Heart size is still normal, but azygous and mediastinal veins are mildly dilated, perhaps an indication of right heart dysfunction or other cause of elevated central venous pressure. Clinical correlation would be wise.

Right PICC line tip is in the right atrium and should be pulled back approximately 3 cm. There is interval resolution of pulmonary edema. There is also interval improvement of bilateral pleural effusions. No pneumothorax is seen.

Radiograph obtained centered at the thoracoabdominal junction was performed for assessment of a nasogastric tube, which terminates within the distal stomach. Heart size is normal, and lungs are clear except for focal linear atelectasis at the lung bases.

Frontal view of the chest was obtained. The heart is normal size. Increased retrocardiac opacity is compatible with known left hilar mass and left lower lobe collapse. Left main stem bronchus stent is in similar position to prior. The right lung is grossly clear, with known nodules better appreciated on CT. No pneumothorax.

The enteric tube and right-sided PICC line appear unchanged position. There is unchanged cardiomegaly and mediastinal prominence. There is persistent prominence of the pulmonary interstitial markings likely due to fluid overload. More focal area of consolidation within the right base is again seen. There are no pneumothoraces. Overall, these findings are relatively stable.

No significant change. There remains possibility of a small right upper lobe nodule. No acute pneumonia.

There has been interval decrease in the amount of vascular plethora. The heart continues to be mildly enlarged. There small bilateral effusions. There is volume loss at the bases.

The patient carries an endotracheal tube. The tip of the tube projects 0.7 cm above the carina. There is a nasogastric tube in situ. The tip projects over the middle part of the stomach. A second tube appears to be outside of the patient. Additional abdominal drains. Low lung volumes. Extensive areas of atelectasis and mild overhydration. No pleural effusions. Borderline size of the cardiac silhouette.

The left-sided PICC line has not changed since the previous exam. It is radiographically at the level of the lower portion of the superior vena cava. Stability of the low lung volumes and bilateral interstitial markings in this patient with known interstitial lung disease. There is no pneumothorax. There are no pleural effusion and no pneumothorax.

There are persistent low lung volumes. Cardiomegaly cannot be assessed. Large right pleural effusion has increased. Underlying consolidation appears to be increased. Moderate pulmonary edema is stable. There is no evident pneumothorax.

As compared to the previous radiograph, there is no relevant change. Right-sided pleural catheter is in situ. No evidence of pneumothorax. The remaining right pleural effusion and the areas of atelectasis are without substantial change. No evidence of pneumothorax. Moderate cardiomegaly. Normal appearance of the left lung.

Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. The right lung is clear. Stable-appearing small left-sided pleural effusion with adjacent atelectasis. Small amount of subcutaneous emphysema along the left chest wall. Persistent moderate cardiomegaly. Three chest tubes project over the left hemithorax.

Mediastinal contours are unremarkable. Dense airspace opacities are present in the lower lungs bilaterally, right more than left. Peribronchial cuffing is noted. A small bilateral pleural effusions very present.

Since the chest radiograph obtained 5 days prior, there is been interval removal of a right-sided IJ central venous catheter and improvement in retrocardiac atelectasis. There is unchanged hyperinflation. The lungs are otherwise clear without focal consolidation or pulmonary nodules. The cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal.

A moderate-to-large right pneumothorax persists. There has been interval decrease in size of its basilar component. The apical component remains essentially unchanged. Chest tubes are in unchanged position. Cardiomediastinal contours are normal. Left lung is clear.

AP upright portable chest radiograph provided. No large consolidation, effusion, or pneumothorax is seen. The heart appears normal in size. The mediastinal contour appears normal. There is a dextroscoliosis of the T-spine. Bony structures are demineralized, though appear intact.

Left PICC line tip is at the level of mid SVC. Right internal jugular line tip is at the level of superior SVC. Bibasal consolidations and bilateral pleural effusions are overall unchanged. No new pneumothorax.

Endotracheal tube tip terminates 3.9 cm from the carina. Orogastric tube tip is within the stomach as is the side port. Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of cardiac silhouette is seen. Calcifications are noted within the AP window, likely within lymph nodes. Moderate pulmonary edema is demonstrated. No large pleural effusion or pneumothorax is present. Clips are noted in the right upper quadrant of the abdomen. There is no pneumothorax.

As compared to the previous radiograph, the pre described right apical tiny pneumothorax is no longer seen. The pre-existing opacities, both at the level of the right upper lobe and right perihilar as well as left perihilar areas have completely resolved. The retrocardiac atelectasis has improved and is now minimal. No new opacities. No pleural effusions. Normal size of the cardiac silhouette.

In comparison with the study of earlier in this date, the right chest tube has been removed and there is no evidence of pneumothorax. The remainder the study is essentially unchanged.

Since prior, left pleural effusion has slightly decreased in size. The lungs are grossly clear. Cardiomediastinal silhouette is unchanged. Small right pleural has resolved. There is no pneumothorax.

A single portable AP upright view of the chest was obtained. Heart is normal size and cardiomediastinal contour is notable for calcifications in the aortic arch. Hyperinflated and hyperlucent lungs are suggestive of emphysema. There is no consolidation, pleural effusion or pneumothorax.

Extensive nodular densities project over the lungs bilaterally consistent with pleural plaques secondary to prior asbestos exposure. Interval improvement of previously seen pulmonary vascular congestion and trace pulmonary edema stable right pleural effusion. With this improvement previously seen left mid lung airspace opacification since consistent with known pleural plaques.

The lung volumes are low. Mild fluid overload but no overt pulmonary edema. Mild cardiomegaly. No pleural effusions. No pneumonia, no pneumothorax.

The left internal jugular venous catheter line has been removed in the interim. A left subclavian approach PICC tip has been retracted in the interim and now projects over expected region of the cavoatrial junction. Lung volumes are low with bronchovascular crowding. Linear bandlike opacity projecting over the left mid lung is probably platelike atelectasis and/or scarring, seen on the prior exam and unchanged. No pleural effusion, pneumothorax, or frank pulmonary edema. No definite focal consolidation.

NG tube tip isin the stomach. Bibasilar atelectasis have markedly increased on the right. There is no evident pneumothorax or enlarging effusions. Cardiomegaly is stable. Stent in the right upper quadrant is again noted.

The patient remains intubated. An endotracheal tube terminates approximately 3 cm above the carina. An orogastric tube courses into the stomach. The right hemidiaphragm is now somewhat obscured with new vague opacification projecting over the right lower lung but sparing the right cardiac border. Elsewhere, the lungs remain clear. There is no definite pleural effusion. There is no pneumothorax.

A skin fold projecting over the left lateral chest should not be mistaken for pneumothorax. Moderate cardiomegaly is accompanied by pulmonary vascular congestion and possibly mild pulmonary edema. Heterogeneous appearance of the lower lungs particularly the right could be due to chronic lung disease, but would make it difficult to detect early pneumonia. There is no pneumonia in the upper lungs. Small right pleural effusion is likely.

Single frontal view of the chest was obtained. Free air is present underneath both hemidiaphragms. Lung volumes are low. The vascular pedicle is widened and there is slightly increased rightward shift of the trachea, which may be projectional. Multi focal ill-defined lung opacities are similar to prior and consistent with history of sarcoidosis although superimposed infection cannot be excluded. No pneumothorax or substantial pleural effusion. Chain sutures in the right mid lung are similar to prior.

AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained seven hours earlier during the same day. The AP single radiograph demonstrates unchanged position of the previously described small caliber pigtail ending pleural drainage catheter. There is no evidence of any remaining apical pneumothorax. However, hazy density occupying the entire left side hemithorax and elevated diaphragm is suggestive of pleural effusions layering in the posterior pleural spaces. The right hemithorax is unremarkable as before.

Feeding tube has been repositioned, now ending in the region of the pylorus. Lung volumes are low but no focal pulmonary abnormality is seen. Heart size probably normal. No pneumothorax or significant pleural effusion. Right pic line ends in the low SVC.

1. Nasogastric tube remains unchanged in position. Right chest tube also remains in place, unchanged. A left subclavian central line has its tip in the distal SVC, unchanged. There continues to be a small left effusion with associated air space opacity most likely representing compressive atelectasis. Bibasilar opacity is also again seen likely representing a combination of postoperative changes and atelectasis. No evidence of pulmonary edema. No pneumothorax. Stable cardiac and mediastinal contours.

Compared to the prior study there is no significant interval change.Trace left pleural effusion versus basilar atelectasis. Otherwise, grossly clear lungs bilaterally

As compared to the prior examination, there has been no significant interval change. The patient is status post VATS right hilar nodal biopsy, and there is no overt pneumothorax identified. A right chest tube is in unchanged location. Small, bilateral pleural effusions are unchanged. Allowing for differences in the patient positioning, the cardiomediastinal silhouette is unchanged.

An endotracheal tube is in place terminating 2.7 cm above the carina. The cardiomediastinal and hilar contours are within normal limits. There are several small foci of peripheral opacity within the right mid and lower lung, concerning for infection or aspiration. The left lung is clear. There is no pleural effusion or pneumothorax.

1. Endotracheal tube now has its tip 3.7 cm above the carina. Right internal jugular central line has its tip in the proximal SVC. Nasogastric tube courses below diaphragm with tip not identified. The lung volumes remain low with persistent retrocardiac opacity and probable layering effusion consistent with compressive atelectasis. Pneumonia cannot be entirely excluded. There is also likely patchy atelectasis at the right medial lung base. No pulmonary edema or pneumothorax. Overall, cardiac and mediastinal contour is stable given differences in patient rotation.

As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are constant. Constant appearance of cervical fixation devices. Moderate cardiomegaly, known post-procedure parenchymal opacities on the right and atelectasis at the left lung bases.

In comparison with the earlier study of this date, the patient has taken a slightly better inspiration. The right subclavian catheter extends to the cavoatrial junction or upper portion of the right atrium. Nasogastric tube extends to the second portion of the duodenum. Opacification at the left base is again consistent with substantial volume loss in the left lower lobe and pleural effusion. Less prominent atelectatic changes are seen at the right base. The pulmonary vascularity is probably within normal limits given the low lung volumes, which accentuate the transverse diameter of the heart.

There is diffuse hazy opacification of the lungs, compatible with edema. There are suspected small bilateral pleural effusions. No pneumothorax is seen. No definite consolidation to suggest pneumonia is seen. There is mild cardiomegaly.

Single supine portable view of the chest. No prior. Lung volumes are low though lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.

There is a nasogastric tube which terminates in the gastric fundus. The cardiac, mediastinal and hilar contours appear unchanged. The heart is probably at the upper limits of normal size. The aortic arch is partly calcified. Lung volumes are somewhat low. The lungs appear clear. There is no pleural effusion or pneumothorax. No free air is seen.

Single portable view of the chest. Low lung volumes are noted. Within limitation of overlying trauma board, the lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No displaced fractures are identified.

AP portable upright view of the chest. Surgical hardware is seen in the cervical spine and right shoulder. A right IJ central venous catheter is again seen with its tip in the region of the low SVC. The lungs are clear bilaterally. There is no pneumothorax. Heart size is mildly enlarged and stable. Mediastinal contour is unremarkable. The bony structures appear intact. Scoliosis partially visualized in the upper lumbar spine.

As compared to the previous image, the nasogastric tube has been advanced. The patient is now intubated. The tip of the endotracheal tube projects 3.8 cm above the carina. No pleural effusions. No pneumonia. No pulmonary edema.

One portable supine AP view of the chest. Right internal jugular catheter tip is in the right atrium. Left PICC line ends at the cavoatrial junction. Tracheostomy tube ends 3 cm from the carina. Bibasilar atelectasis and small left pleural effusion are unchanged. No focal parenchymal opacity is concerning for pneumonia. Cardiac, mediastinal, and hilar contours are stable.

Support lines and tubes including right-sided pacemaker are unchanged in position. There is cardiomegaly which is stable. There is a persistent left retrocardiac opacity and left-sided pleural effusion, unchanged. There are no signs for overt pulmonary edema or pneumothoraces.

Compared to the prior study there is no significant interval change.

In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the upper stomach. However, the sidehole is above the level of the esophagogastric junction and the tube should be pushed forward at least 6 cm. Little change in the appearance of the heart and lungs.

No previous images. Cardiac silhouette is within normal limits and there is no evidence of vascular congestion or pleural effusion. Minimal atelectatic streaks above a slightly elevated left hemidiaphragm. No acute pneumonia.

In comparison with the earlier study of this date, the left chest tube has been removed. No convincing evidence of pneumothorax. Otherwise, little change from the earlier study of this date.

As compared to the previous radiograph, the lungs have increased in transparency and the signs indicative of pulmonary edema have decreased in severity. No new focal parenchymal opacities. No pleural effusions. Unchanged elevation of the right hemidiaphragm. Unchanged moderate cardiomegaly.

A small left-sided pneumothorax is probably unchanged. There has been no significant short-term change.

Allowing for differences in technique, there has not been a relevant change in the appearance of the chest since the recent radiograph of 1 day earlier.