Datasets:
ayyuce
/
mimic-cxr

Dataset card Data Studio Files Community
1
image
imagewidth (px)
512
512
reports
stringlengths
35
2.1k
Low lung volumes accentuate cardiomediastinal silhouette. There is no focal lung consolidation. There is no pleural effusion or pneumothorax. There is a possible right lateral rib fracture. No evidence of pneumonia. Possible right lateral rib fracture.
An NG tube is present, tip lies over the right mid abdomen, possibly in the gastric antrum, though notably distal. No free air seen beneath the diaphragms Inspiratory volumes are low, resulting in prominence of the cardiomediastinal silhouette and bronchovascular crowding. There is upper zone redistribution, but doubt overt CHF. Bibasilar atelectasis. No definite infiltrate. No consolidation or effusion detected. NG tube tip overlying the right abdomen, possibly in the gastric antrum, though notably distal. Low inspiratory volumes with bibasilar atelectasis, but no definite infiltrate to suggest a focus of aspiration.
Right pectoral infusion port terminates in mid SVC. Transesophageal tube terminates in the stomach. Lung volume is low. Left perihilar opacity is slightly increased. Right lung base opacity is slightly increased. There is no large pleural effusion. Cardiomediastinal silhouette is unchanged. Diffuse sclerotic changes of the bones are again noted. Slightly increased bibasilar opacities may reflect aspiration and/or pneumonia.
Indwelling supportive and monitoring devices are unchanged and in appropriate position. Lung volumes are low with new patchy bibasilar opacities. Mediastinal contours, hila, cardiac silhouette is unchanged from . No pleural effusion or pneumothorax. Right axillary surgical clips and diffuse sclerotic skeletal metastatic disease are unchanged. New patchy bibasilar opacities likely represent atelectasis although aspiration is another consideration.
The right-sided Port-A-Cath tip terminated in mid SVC. The NG tube appears to have been pulled back but the side port is below the level of the diaphragm and the tip terminates in the stomach. Surgical clips are seen in the right axilla. There are no complications nor pneumothorax seen. Bilateral lung volumes are low. The heart size is top normal. Diffuse bony sclerosis and hyperdense vertebral bodies consistent with known bone metastasis are again noted and are stable and unchanged from prior study. Port-A-Cath, ET tube, and NG tube are in stable and unchanged positions.
Right-sided Port-A-Cath in situ with tip in the mid SVC. Nasogastric tube in situ projecting over the stomach. ECG leads on the chest. Surgical clips in relation to the right axilla. No airspace consolidation. No pleural effusions. No pneumothorax. The heart size is at the upper limits of normal. Unfolding of the thoracic aorta with associated atherosclerotic calcifications. Diffuse bony sclerosis consistent with an osseous metastasis. Tubes and lines as described above. No acute pneumonic process.
Right-sided Port-A-Cath tip terminates in the upper SVC. An orogastric tube tip is within the distal stomach. Heart size is mildly enlarged. The aorta is unfolded with atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Lung volumes are low with mild bibasilar atelectasis. No pleural effusion or pneumothorax is seen. Multiple clips are noted in the right axilla. Standard positioning of all lines and tubes. Mild bibasilar atelectasis.
Interval placement of a left pigtail thoracostomy drain with tip in the left apex. Persistent, though decreased, left apical pneumothorax. Right chest port and left subclavian line are unchanged. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bibasilar atelectasis. Lungs are otherwise clear. No pleural effusion is seen. There are no acute osseous abnormalities. Interval placement of a left apical pigtail thoracostomy drain. Persistent, though decreased, left apical pneumothorax.
The patient has been extubated in the interim. The NG tube, mediastinal drains and a left-sided chest tube has been removed. Epicardial pacing wires are again noted. A right internal jugular catheter terminates in the distal SVC. There is no pneumothorax. Blunting of the left costophrenic angle may reflect atelectasis. There is no focal airspace consolidation. An evolving postoperative appearance of the mediastinum is noted. The heart is normal in size. The stomach is distended and elevates the left hemi-diaphragm. No pneumothorax after chest tube removal. Distended stomach elevating the diaphragm after NGT removal. atelectasis
The right-sided PICC line tip is in the mid SVC. There is increase in bilateral hazy alveolar infiltrate in indistinct vascularity with increased cardiomegaly and small to moderate bilateral pleural effusions compatible with fluid overload. Worse in fluid status.
A nasogastric tube has been placed and it terminates in the stomach. The cardiac, mediastinal and hilar contours appear stable. Patchy opacities are probably similar, allowing for small differences in technique, suggesting atelectasis. No free air is identified. Dilatation of bowel in the upper abdomen is better described in a separate abdominal report of the same day. Nasogastric tube terminating in the stomach.
An NG tube extends below the diaphragm with the tip out of view to the inferior edge of the image. Stable top-normal heart size, mediastinal and hilar contours. Unchanged left lower lobe opacity with small left pleural effusion. No pneumothorax. NG tube in stomach. with Dr.
Overall, there has been no significant interval change in the mild-to-moderate bilateral pulmonary edema. There has been a slight interval increase in the small left pleural effusion, with a persistent small right pleural effusion. Prominence of the cardiomediastinal contours are likely secondary to low lung volumes, however, mild cardiomegaly has been persistent compared to exams dated back to . There is no evidence of a pneumothorax. Visualized osseous structures are unremarkable. Right sided PIC line terminates in the mid SVC. No significant interval change in the extent of the moderate pulmonary edema. Slight interval increase in a small left pleural effusion.
Portable semi-upright radiograph of the chest demonstrates an area of increased opacification in the right mid lung, which likely represents a right lower lobe consolidation representing either atelectasis or pneumonia. There are small bilateral pleural effusions with adjacent atelectasis. There is no pneumothorax. A right-sided PICC line ends in the mid SVC. Nasogastric tube courses into the stomach out of the field-of-view. The cardiomediastinal and hilar contours are unchanged. Severe degenerative changes are seen in both shoulder joints and intact cervical plate is present There is an area of increased opacification in the right mid lung, which likely represents a right lower lobe process. This may represent atelectasis or pneumonia.
ET tube, NG tube, and right-sided PICC line are similar in position. Fixation hardware in the lower cervical spine is noted, not fully evaluated. Allowing for low inspiratory volumes and lordotic positioning, the overall appearance is similar. The cardiomediastinal silhouette is probably unchanged. There is CHF, with vascular plethora and blurring. There is increased retrocardiac density consistent with left lower lobe collapse and or consolidation. A small left effusion cannot be excluded. As above.
A right-sided PICC is in the mid SVC and is unchanged in position. An enteric tube is seen coursing below the level of the diaphragm however its tip is not clearly identified. There is increased opacity throughout both lungs consistent with persistent pulmonary edema and significant bibasilar atelectasis. There is no evidence of pneumothorax. Persistent pulmonary edema and bibasilar atelectasis minimally increased from the prior study.
A right PICC is seen in unchanged position. There is increased opacity in the bilateral lung bases compared with prior exam, concerning for aspiration or pneumonia. The opacity at the right lung base demonstrates a well-defined border on one side, which could reflect pleural fluid in the fissure. Bilateral pleural effusions are seen. There is no pneumothorax. The cardiomediastinal silhouette is unremarkable. Increased opacity in the bilateral lung bases, concerning for aspiration or pneumonia.
Right-sided PICC terminates in the mid SVC and is unchanged. Lung volumes are markedly low. Given that, cardiomediastinal and hilar contours are unchanged. There is significant atelectasis of the left base. There is no evidence of pneumonia. There are small bilateral pleural effusions. No evidence of pneumothorax Severe left basal atelectasis and small bilateral pleural effusions, improved since . There is no evidence of pneumonia.
There are low lung volumes and a suboptimal inspiratory effort. Allowing for changes due to this, the cardiomediastinal silhouettes are within normal limits. Diffuse, centrally predominant interstitial opacities are consistent with pulmonary vascular congestion. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. Mild pulmonary edema.
In comparison with the study of , there has been a left upper lobectomy with relatively small pneumothorax. Chest tube is in place. Small amount of gas is seen in the subcutaneous tissues along the left lateral chest wall. Minimal atelectatic changes are seen at the bases. Of incidental note is a small opacification inferior to the glenoid on the left, representing either a previous avulsion or calcific tendinosis in the subscapularis. Small left pneumothorax following left upper lobectomy.
A NG tube ends in the stomach. Right IJ ends at the cavoatrial junction. There is no pneumothorax. There is a small left pleural effusion and left basilar atelectasis. There is only mild vascular congestion. There is a left retrocardiac opacity likely representing atelectasis. Appropriate position of lines and tubes. No pneumothorax. Left retrocardiac opacity likely representing atelectasis.
Heart size is upper limits of normal. Lungs are relatively clear without focal consolidation, pleural effusions or pulmonary edema. There is some elevation of the right hemidiaphragm. Degenerative changes of the AC joints are seen bilaterally. No signs for acute cardiopulmonary process.
Shallow inspiration accentuates heart size, pulmonary vascularity. Patchy bibasilar opacities, likely atelectasis. No pleural fluid Shallow inspiration.
No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable, grossly stable as compared to the scout radiograph from chest CT from . The mediastinum is not widened. No pulmonary edema is seen. No displaced fracture is identified. No acute cardiopulmonary process. The mediastinum is not widened.
AP portable upright view of the chest. No free air is seen below the right hemidiaphragm. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No acute intrathoracic process. No signs of free air below the right hemidiaphragm.
The ET tube ends in the lower trachea. A right IJ central venous catheter ends in the mid SVC. An OG tube enters the stomach, distal tip not visualized. The lungs are clear. There is no pneumothorax. The heart and mediastinum are within normal limits despite the projection. Newly placed OG tube enters the stomach, distal tip not visualized. Clear lungs.
AP portable chest radiograph was obtained. Diffuse interstitial abnormality with interval increased cardiomegaly is consistent with moderate pulmonary edema. No pleural effusion or pneumothorax is identified. There is no focal consolidation. Dual lead pacemaker and ICD is noted with leads in conventional position. Mediastinal contours are unremarkable. Patient is status post CABG. Moderate pulmonary edema.
There is moderate interstitial pulmonary edema; concurrent pneumonia, particularly in the right lower lobe, is not excluded. The heart is moderately enlarged, increased in size compared to the prior radiograph from . A curvilinear radiodense structure paralleling the right hemidiaphragm may also be pleural calcification. There are no definite pleural effusions. No pneumothorax is seen. The mediastinal contours are normal. Moderate pulmonary edema. Concurrent pneumonia is not excluded. -mm nodular opacity projecting over the left retrocardiac region could be a pulmonary nodule or pleural calcification. Curvilinear radiodensity projecting over the right hemidiaphragm may also be pleural calcification. Moderate cardiomegaly, increased compared to the prior study from .
The cardiac silhouette continues to be enlarged, but without gross change. Again noted is a left-sided pacemaker type device with appropriate position of leads over the right atrium and right ventricle. No gross effusions identified on this AP film. No pneumothoraces detected. Cardiomegaly with moderate pulmonary edema.
There has also been interval placement of a nasogastric tube which appears to terminate below the level of the diaphragm and outside the view of this radiograph. Of note, the inferior edge of this film probably lies in the region of the GE junction. Again seen is cardiomegaly, with pulmonary edema. There has probably been slight improvement in the appearance of the right upper lobe. Possible slight improvement in the degree of interstitial edema in the left upper lobe. Interval placement of endotracheal tube and nasogastric tube, detailed above. Possible slight interval improvement in pulmonary edema findings, but the overall appearance is quite similar.
Single portable radiograph of the chest demonstrates a right PICC line projecting over the upper portion of the SVC. Compared to the prior radiograph, there is interval decrease in lung volumes and no other relevant change. Interval placement of right-sided PICC line projecting over the upper portion of the SVC.
Compared to the prior study there is no significant interval change. Lung volumes are low and there is vascular plethora. An underlying infectious infiltrate in the lower lobes cannot be exclude No significant change compared to prior
Chest, portable. The right middle lobe opacity has resolved. The lungs are clear. An unfolded aortic configuration is again noted. The hilar and cardiac contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. The right middle lobe opacity has resolved and the lungs are now clear.
An NG tube tip is seen coiling within the fundus of the stomach. As compared to prior chest radiograph from , there is increased retrocardiac atelectasis. There is asymmetric apical thickening, left worse than right, which is likely related to scarring and radiation fibrosis. The lungs are otherwise clear. The cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. NG tube tip coils in the fundus of the stomach.
Moderate central pulmonary vascular congestion is associated with moderate to severe interstitial pulmonary edema, predominantly in the bilateral lung bases. Small bilateral pleural effusions are likely. There is no pneumothorax or definite focal consolidation. The cardiomediastinal contour, including mild cardiomegaly, is unchanged. The osseous structures and upper abdomen are unremarkable. Moderate central pulmonary vascular congestion with associated moderate to severe interstitial pulmonary edema.
There is left perihilar opacity that is slightly more confluent today compared to prior, possibly from atelectasis and worsening edema. The moderate to severe pulmonary edema is possibly worsening. The right upper lobe is clear. Cardiomegaly is likely unchanged. The aortic knob calcification is unchanged. New ETT in standard position. Moderate to severe pulmonary edema, worsening. Mild increase in bilateral pleural effusion.
Moderate enlargement of the cardiac silhouette is re- demonstrated. The mediastinal contour is unchanged with atherosclerotic calcifications noted at the aortic knob. Moderate to severe pulmonary edema appears minimally worse compared to the previous study with continued small bilateral pleural effusions. More focal opacities at the lung bases may reflect areas of atelectasis. No pneumothorax is present. There are no acute osseous abnormalities. Slight interval worsening of moderate to severe pulmonary edema and continued small bilateral pleural effusions.
The lungs are well expanded without focal opacities. Moderate-to-severe cardiomegaly is unchanged from prior. There is no pleural effusion or pneumothorax. There is stable elevation of the left hemidiaphragm. No evidence of subdiaphragmatic free air. Moderate-to-severe cardiomegaly. No evidence of subdiaphragmatic free air.
AP view of the chest provided. There are lower lung opacities most compatible with atelectasis. Suture material is noted in the right mid lung. No large effusion or pneumothorax. No convincing signs of pneumonia. The heart size cannot be assessed. Clips are noted in the left upper abdomen. There is no pneumothorax. Bony structures appear intact. Lower lung opacities, most compatible with atelectasis.
Single frontal view of the chest. Endotracheal tube, NG tube, single lead left chest wall defibrillator, and right PICC are in stable position. Lung volumes are low with slight asymmetric elevation of left hemidiaphragm. No focal consolidation, pleural effusion, or pneumothorax. Heart size and mediastinal contours are normal. No focal consolidation.
Portable semi-upright radiograph of the chest demonstrates bibasilar atelectasis, significantly increased from the prior study. There are low lung volumes which results in bronchovascular crowding. A right-sided PICC line ends at the cavoatrial junction. Single-lead pacemaker is in unchanged position. A VP shunt projects over the left hemithorax. Interval increase in bibasilar atelectasis.
The right PICC ends in the lower SVC with interval removal of the right internal jugular catheter. Nasoenteric tube ends within the stomach. ICD lead ends in the right ventricle. Low lung volumes results in bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Left basilar consolidation has improved. Cardiac and mediastinal silhouettes and hilar contours are stable. No pneumonia, edema, or effusion.
Enteric tube terminates in the stomach. Right internal jugular central venous catheter and AICD lead are in unchanged position. Aeration of both bases is improved with linear right basilar atelectasis remaining. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unchanged. Enteric catheter terminates within the stomach.
Portable AP chest radiograph demonstrates interval placement of enteric feeding tube with its tip at the distal stomach. A left pectoral replaced pacer with a single intact lead follows the expected course terminating in the right ventricle. There is no overt pleural effusion. Cardiomediastinal and hilar contours are stable. No focal consolidation is identified. Mild vascular congestion is identified. Dobbhoff tube in appropriate position. Mild vascular congestion. No focal consolidation.
As compared to prior examination dated , there has been no significant interval change. Again, the lungs are hyperexpanded bilaterally with flattening of the hemidiaphragms and apical scarring, compatible with chronic obstructive pulmonary disease. Redemonstrated is a right apical airspace consolidation. There is no pleural effusion. The cardiomediastinal silhouette is stable. A large hiatal hernia is noted. Right upper lobe airspace consolidation, compatible with pneumonia in the proper clinical setting.
Again seen is a right upper lobe opacity, similar to examinations. There is subtle increase in opacity at the right and left lung bases, possibly reflecting atelectasis, though underlying new consolidations cannot be entirely excluded. There is no pneumothorax or pleural effusion. The cardiac and mediastinal contours are unchanged. Unchanged right upper lobe opacity. If this does not resolve following treatment, a CT examination should be considered. New subtle right and left bibasilar opacities likely reflect atelectasis, though early consolidations cannot be excluded.
The lungs are clear. There is stable moderate cardiomegaly. There is rightward tracheal deviation, more prominent when compared to prior studies. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. No acute cardiopulmonary process. Left paratracheal density with rightward tracheal deviation, more prominent than on prior studies. This could be due to enlarged thyroid, although none was seen on prior thyroid ultrasound, or other soft tissue. This could be further evaluated with outpatient thyroid ultrasound or CT.
Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is new atelectasis at the right base with increase in elevation of the right hemidiaphragm and medial right base opacity. There is rightward deviation of the trachea and stable moderate cardiomegaly. There is no pneumothorax or pleural effusion. A nasogastric tube is present, ending in the stomach. Nasogastric tube ends in the stomach. New/increased atelectasis at the right lung base.
Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Atelectasis at the right base is again seen, possibly slightly improved. There is rightward deviation of the trachea, and stable moderate cardiomegaly. There is no pneumothorax or pleural effusion. A nasogastric tube is present, ending in the stomach. Nasogastric tube ends in the stomach.
The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. No evidence of acute cardiopulmonary disease.
Compared to the prior study there is no significant interval change. No change.
A portable AP view of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. There is no free air. No acute cardiopulmonary process.
ET tube, NG tube and right pleural tube are in unchanged satisfactory position. Worsening heterogeneous opacity in the right lower lung are likely related to worsening pneumonia and enlarging pleural effusion. Left pleural effusion also larger since yesterday. Pulmonary vascular congestion in the bilateral upper lungs worse since yesterday. No change in cardiomediastinal silhouette. No pneumothorax. Right lower lung heterogeneous opacity worsened since yesterday likely due to worsening pneumonia and increasing pleural effusion. Increased pulmonary vascular congestion since yesterday. Telephone notification to Dr. By Dr
NG tube and left PICC line unchanged in satisfactory position. No significant change in bilateral pleural effusion, bibasilar opacities and mild pulmonary edema since yesterday. Low lung volumes exaggerate heart the heart size. No pneumothorax. No significant change in bilateral effusions, bibasilar opacities and mild pulmonary edema.
Single AP upright portable view of the chest was obtained. No focal consolidation is seen. There is minimal elevation of the right hemidiaphragm. There is no large pleural effusion. No evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen. Minimal elevation of the right hemidiaphragm. Otherwise, no acute cardiopulmonary process.
Cardiac size is normal. Left lower lobe opacities could correspond to atelectasis or pneumonia in the appropriate clinical setting. There is no pneumothorax or pleural effusion. Left lower lobe opacities could correspond to atelectasis or pneumonia in the appropriate clinical setting
Assessment of the chest is limited by overlying trauma board and external devices. Enteric tube tip terminates in the stomach, however the side port is above the gastroesophageal junction. Heart size is mildly enlarged. Widening of the superior mediastinum may be due to low lung volumes, supine positioning, and AP technique. Ill-defined opacities are seen within both upper lobes and likely within the medial aspect of the right lung base, which may reflect areas of aspiration. No large pleural effusion or pneumothorax is identified on this supine exam. There is no overt pulmonary edema identified. No displaced fractures are evident. Study limited by overlying trauma board and external devices. Ill-defined opacities in both upper lobes and likely within the medial aspect of the right lung base may reflect areas of aspiration.
The patient is status post CABG with intact sternotomy wires. There is stable mild cardiomegaly. The aorta is tortuous and minimally calcified; there is minimal linear atelectasis at the left lung base. There is no airspace consolidation or edema. There is no pneumothorax or pleural effusion. No acute process.
The lungs are grossly clear without focal consolidation, large effusion or overt pulmonary edema. The cardiac silhouette is enlarged but similar compared to prior. Median sternotomy wires and mediastinal clips are again noted. Known compression deformities in the spine are not clearly delineated on this exam. No acute cardiopulmonary process.
There is a new small left pleural effusion. A new left basilar retrocardiac airspace opacity may be due to infection or aspiration. Mild cardiomegaly despite the projection is unchanged. There is no pneumothorax. Stable prominent paratracheal soft tissues are likely due to an enlarged thyroid gland. New small left pleural effusion. New left lower lobe airspace opacity may be due to atelectasis or infection. Stable mild cardiomegaly. Stable thyromegaly.
AP upright portable view of the chest was provided. There is scarring in the right mid-to-lower lung with pleural thickening, similar to prior CT scan. Pleural thickening and scarring at the left lung base is also similar to prior, likely accounting for the blunted appearance of the bilateral CP angle. Cardiomediastinal silhouette appears normal. No definite signs of pneumonia or CHF. No pneumothorax. There is an old deformity of the left clavicular mid shaft. No acute bony abnormalities. Stable scarring in the lungs as better assessed on prior CT chest. No definite signs of superimposed pneumonia.
Single portable view of the chest is compared to previous exam from . The lungs are clear of confluent consolidation. There is indistinctness of the pulmonary vascular markings suggestive of vascular congestion. There is no large confluent consolidation nor pneumothorax. Cardiomediastinal silhouette is unchanged. Osseous and soft tissue structures are unremarkable. Pulmonary vascular congestion.
The lungs are hyperinflated, likely reflecting chronic pulmonary disease. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no overt pulmonary edema. The heart is normal in size. A well-circumscribed round opacity along the right heart border may reflect a Bochdalek's hernia. Calcifications are noted along the aortic arch, and no displaced rib fractures are seen. S-shaped scoliosis of the thoracolumbar spine is noted. No acute cardiopulmonary process. .
Re-identified are bilateral glenohumeral prosthetic devices. There is significant rightward rotation of the patient on the current radiograph. Allowing for changes due to this, the cardiomediastinal silhouettes are stable, reflective of moderate cardiomegaly. There is pulmonary vascular congestion and possibly early or mild pulmonary edema. There is bibasilar atelectasis. There is no definite focal lung consolidation, however the right lung is at least partly obscured medially and at its inferior aspect due to patient rotation, making evaluation of the right lung difficult. There is no pneumothorax. There is no sizable pleural effusion, although difficult to exclude trace left pleural effusion. Limited study due to rotation and low lung volumes. Pulmonary vascular congestion and possible early or mild pulmonary edema. No definite focal consolidation, however there is limited evaluation of the right lung due to patient rotation. If there is continued clinical concern for pneumonia, recommend repeat chest radiograph with improved inspiratory effort and technique.
The heart is mildly enlarged, unchanged from prior. There is no pleural effusion or pneumothorax. Mild fullness of the right hilum is seen dating back to . No focal consolidation is seen. Linear opacity at the left lung base likely represents atelectasis. There is no acute osseous abnormality. No definite signs of pneumonia. Lateral view may aid in overall assessment if there is strong clinical concern.
Portable AP upright chest radiograph obtained. The lungs appear essentially clear bilaterally without signs of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette appears grossly unremarkable. Bony structures are intact. No acute intrathoracic process.
There has been interval placement of an enteric tube with tip in the stomach. Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Mild cardiomegaly is re- demonstrated. The mediastinal and hilar contours are unchanged. There is minimal atelectasis at the lung bases. Remainder of the lungs are clear. No pleural effusion or pneumothorax is seen. No subdiaphragmatic free air is present. Diffuse gaseous distention of bowel loops are noted in the upper abdomen. S-shaped scoliosis of the thoracolumbar spine with fusion hardware is incompletely imaged. Nasogastric tube tip within the stomach.
Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. The heart size is mildly enlarged. The aorta is slightly unfolded. Mediastinal and hilar contours are unchanged. Calcification within the medial aspect of the right upper lung field likely reflects a calcified granuloma. There is minimal atelectasis at the lung bases. No focal consolidation, pleural effusion or pneumothorax is seen. Lungs are hyperinflated suggestive of underlying COPD. There is no pulmonary vascular engorgement. Remote right-sided rib fractures are present. Mild bibasilar atelectasis.
A single portable AP chest radiograph was obtained. Medial bilateral lung base opacities may be due to aspiration, although underlying infection not excluded. There is a possible calcified right diaphragmatic plaque. The bilateral costophrenic angles are blunted. There is no pneumothorax. Cardiomegaly is moderate. Multiple old right sided rib fractures are seen. Medial bilateral lung base opacities may be due to aspiration, although underlying infection not excluded. Questionable trace pleural effusions may be further evaluated with a lateral view.
Single frontal view of the chest. Lung volumes are low, exaggerating heart size, which is top normal. Cardiomediastinal contours are unremarkable. Undulating contours of aortic calcifications could represent an ectatic aorta. Retrocardiac and right lung base linear opacities are compatible with atelectasis. Indistinct appearance of the left costophrenic angle suggests a small pleural effusion. No pneumothorax. No radiopaque foreign body. Low lung volumes with bibasilar atelectasis and possible small left pleural effusion. Heavily calcified and tortuous aorta, which could be re-evaluated with conventional radiographs.
A single portable AP chest radiograph was obtained. The lungs are well expanded. Curvilinear opacities in the right lower lobe are compatible with atelectasis and scarring. There is no consolidation all effusion or pneumothorax. A right-sided PICC line tip terminates in the low SVC. Mild cardiomegaly and aortic enlargment are unchanged. The upper trachea is mildly deviated to the right. Right basilar atelectasis, mild cardiomegally, and stable tracheal deviation.
Study is slightly limited by patient rotation. The heart size remains mildly enlarged. Mediastinal and hilar contours are relatively unchanged. New focal opacity is seen within the right lung base. Patchy opacity is also seen within the left lung base. Small bilateral pleural effusions are likely present. There is crowding of the bronchovascular structures as a result of low lung volumes. No pneumothorax is identified. No acute osseous abnormality is present. New right basilar opacity concerning for pneumonia. Probable small bilateral pleural effusions and left basilar atelectasis.
The cardiac, mediastinal and hilar contours appear unchanged. The pulmonary vasculature shows upper zone redistribution with indistinct margins suggesting mild vascular congestion. There is also more focal but vague patchy opacification at the left lung base, the latter possibly atelectasis. There is no definite pleural effusion. There is no pneumothorax. Moderate right-sided diaphragmatic elevation appears similar. Findings suggest mild vascular congestion. Patchy left basilar opacification, which is probably compatible with atelectasis but the possibility of infection could be considered in the appropriate clinical setting. In that event short-term follow-up radiographs may be helpful to reassess.
There has been an interval increase in bilateral pulmonary vascular engorgement and mild pulmonary edema. There has also been an increase in a left lower lobe consolidation with a small left pleural effusion. Mild right sided atelectasis is slightly improved. The ET tube is in standard position. Right-sided IJ is in the mid SVC. The hilar and mediastinal contours are otherwise stable. The heart size is mildly enlarged and stable compared to exams dating back to at least . There is an enteric tube, which courses below the diaphragm with the tip out of the scope of the film. Increase in bilateral pulmonary engorgement and mild pulmonary edema. Increase in left lower lobe opacity concerning for worsening atelectasis or new infection. Slight interval improvement of mild right sided atelectasis.
There is a right-sided IJ, which terminates in the upper to mid superior vena cava with no visible pneumothorax. The enteric tube courses below the diaphragm with the tip out of the scope of the view of the film. Given the distribution, this is concerning for mucus plugging involving the bronchus intermedius. There has been a slight interval increase in the patchy and linear left lower lobe atelectasis at the left base compared to the most recent exam. There is a stable small left pleural effusion. No new focal consolidations are identified. There is no pneumothorax. Mild cardiomegaly is stable at least since . The hilar and mediastinal contours are unremarkable. No acute interval changes concerning for development of pneumonia. Slight interval increase in the left lower lobe atelectasis. Persistent opacity in the right mid and lower lung concerning for atelectasis, possibly due to mucous plugging in the bronchus intermedius.
The cardiac, mediastinal, and hilar contours appear unchanged. There is similar moderate relative elevation of the right hemidiaphragm compared to the left. A prominent pericardial fat pad is again noted along the left apex, obscuring the costophrenic sulcus, and accordingly making it difficult to exclude a small pleural effusion. There is no evidence for pleural effusion on the right. There is no pneumothorax. Although right basilar opacity has mostly resolved, leaving only a streaky residual linear opacity suggesting minor scarring or atelectasis, there is a patchy new retrocardiac opacity in the left lower lobe, raising concern for pneumonia. Atelectasis would be a differential consideration, however. Patchy opacity in the left lower lobe, non-specific possibly due to pneumonia in the appropriate clinical setting.
Portable AP view of the chest. Relatively low lung volumes are seen compared to prior. There are bibasilar opacities with more dense consolidation identified in the retrocardiac region which silhouettes the descending thoracic aorta and medial hemidiaphragm. Superiorly the lungs are clear. Cardiomediastinal silhouette is unchanged given differences in positioning and technique. Osseous structures are unremarkable. Bibasilar opacities, more confluent at the left lung base compared to the right. Although a component of this may be due to atelectasis, underlying consolidation is also possible particularly on the left. PA and lateral views with improved inspiratory effort may help further characterize if desired.
Right mid and lower lung airspace opacification is similar to the prior study and consistent with a right lower lobe pneumonia, as previously described. There is no pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is partially obscured an otherwise normal. Unchanged right lower lobe pneumonia. No pulmonary vascular congestion or pulmonary edema.
The right lung base pigtail chest tube has also been removed. No radiographic evidence of tension physiology. The cardiomediastinal silhouette is stable. Re-identified are aortic arch calcifications. Surgical clips project over the midline and right hemiabdomen, as as do surgical skin , as on prior. Retrocardiac opacity is unchanged. The ill-defined right lower and mid lung hazy opacification is also stable. There is no new focal lung consolidation. There is no left pneumothorax. There are a probable trace left pleural effusion. Small right apical pneumothorax status post right chest tube removal. Patchy right mid lung opacity may reflect atelectasis, however it is difficult to exclude aspiration or infection the appropriate clinical setting. Unchanged left basilar atelectasis. Probable trace left pleural effusion. D. by , M. D.
There is no consolidation, pneumothorax or large pleural effusion. Cardiomediastinal and hilar silhouettes are normal size. No acute cardiopulmonary process.
No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No acute cardiopulmonary process.
The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax. No acute cardiac or pulmonary findings.
Cardiac silhouette size is normal. Focal prominence of the descending thoracic aortic contour at the level of the AP window corresponds to the previously noted focal type B aortic dissection with saccular aneurysm seen on recent CT. No acute cardiopulmonary abnormality otherwise demonstrated. Hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is identified. Focal prominence of the descending thoracic aortic contour at the level of the AP window corresponds to the previously noted focal type B aortic dissection with saccular aneurysm seen on CT. No acute cardiopulmonary abnormality otherwise demonstrated. No acute cardiopulmonary abnormality otherwise demonstrated.
Lordotic positioning. Inspiratory volumes are slightly low. The heart is not enlarged. There is minimal upper zone redistribution, without other evidence of CHF. No focal infiltrate or effusion is identified. Minimal atelectasis both lung bases is noted. No pneumothorax is detected. No free air seen beneath the diaphragm. Slightly low inspiratory volumes, with minimal bibasilar atelectasis. Otherwise, no acute pulmonary process identified.
Right-sided Port-A-Cath is again seen with catheter tip projecting over the lower SVC. Enteric tube is seen within the esophagus but is kinked and tip extends superiorly, projecting over the level of the aortic arch. The lungs are grossly clear. The cardiomediastinal silhouette is stable given differences positioning. Posterior spinal fixation hardware is identified. Surgical clips seen at the thoracic inlet on the right. No free intraperitoneal air seen below the diaphragm. Enteric tube is folded in the distal esophagus with tip projecting over the region of the aortic arch. Repositioning is suggested.
Chest radiograph Support lines and tubes are unchanged in appearance compared to the prior study. Lung volumes are also unchanged, there is persistent left basilar atelectasis. There is increasing opacification seen at the right lung base suspicious for right middle lobe consolidation. Mild cardiomegaly and prominence of the pulmonary vascular is consistent with congestive heart failure, unchanged compared to the prior study.
Support lines and tubes are unchanged in appearance when compared to the prior study. There is persistent silhouetting of the left hemidiaphragm consistent with left lower lobe atelectasis, superimposed infection cannot be excluded. No pneumothorax or pleural effusion seen. No consolidation seen. Even allowing for the projection, the heart appears mildly enlarged with mild pulmonary vascular congestion. No significant interval change when compared to the prior study.
Enteric tube passes below the inferior field of view, side-port past the GE junction. Right central venous catheter tip projects over the lower SVC. There is no confluent consolidation. Pulmonary vascular congestion is noted. Cardiomediastinal silhouette is unchanged. Additional catheter projects over the upper abdomen and cardiac silhouette to be correlated clinically (external?) Interval placement of endotracheal tube and enteric tubes as above.
Right-sided central venous catheter seen with tip at the RA SVC junction. There is no pneumothorax. The lungs are clear. There is no large effusion or consolidation. Moderate cardiomegaly is similar compared to prior. S-shaped thoracic scoliosis is again noted. Cardiomegaly without superimposed acute cardiopulmonary process.
Right PICC tip is in the lower SVC. Moderate cardiomegaly is stable. Bibasilar opacities larger on the left side have slightly increased on the left, a combination of effusion and atelectasis. Moderate pulmonary edema has progressed. There is no pneumothorax No pneumothorax. Worsening pulmonary edema, effusion and bibasilar atelectasis.
Support lines and tubing are unchanged in position when compared to the prior study. Catheter tubing projecting over the left heart border is presumed to represent a pericardial drain. Lung volumes are unchanged compared to the prior study with persistent left lower lobe atelectasis. Mild prominence of the pulmonary vasculature with haziness of the upper lobe pulmonary vessels consistent with a mild degree of congestive heart failure. No pneumothorax seen. A hazy airspace opacity in the left lower lung is similar when compared to the prior study and likely represents atelectasis. No significant interval change when compared to the prior study.
The lungs are clear, the cardiac and mediastinal contours are normal, there is no pleural effusion or pneumothorax. No displaced rib fractures are identified. No clavicular or humeral head fractures are seen. Surgical clips seen in the right upper quadrant. No evidence of trauma or acute cardiopulmonary process.
There are low lung volumes with mild bibasilar atelectasis. No focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. Low lung volumes with bibasilar atelectasis. No focal consolidation seen. No overt pulmonary edema.
An enteric tube tip is within the stomach. The side port is not well assessed, but likely is at the GE junction. Heart size is normal. The aorta is tortuous. Fullness of the hila is noted bilaterally. No pulmonary edema is seen. Streaky opacity within the left lung base likely reflects atelectasis. No pleural effusion or pneumothorax is seen. No displaced fractures are visualized. Standard position of the endotracheal tube. Enteric tube tip within the stomach, but the side port is likely at the GE junction, and should be advanced. Left basilar atelectasis. Fullness of both hila, which could reflect underlying lymphadenopathy.
A single portable AP chest radiograph was obtained. Bibasilar scarring and atelectasis is similar. Trace bilateral pleural effusions are slightly larger. No new consolidation is present. A right pigtail catheter is in unchanged position. There is no pneumothorax. An unused pacing lead extends from the right chest to the right atrium. Unchanged bibasilar atelectasis and scarring. Increase of trace bilateral pleural effusions.
The right-sided chest tube and endotracheal tube has been removed. Residual pacemaker wire, nasogastric tube, and left-sided chest tube remain. A small right apical pneumothorax is seen. However it is decreased since the prior study. There is a left retrocardiac opacity. There is some increased opacity within the right mid lung field. The left-sided central venous catheter tip is unchanged. Small right apical pneumothorax which is decreased since the prior radiograph. There has been removal of the right-sided chest tube. Developing opacity within the right mid lung field and left retrocardiac opacity which is stable.
Cardiomediastinal and hilar contours are stable. Pulmonary vascular engorgement with mild pulmonary edema is seen. Bibasilar opacities likely reflect a combination of atelectasis and edema. No pneumothorax. No large pleural effusion. Pulmonary vascular engorgement with mild edema. Trace basilar opacities likely reflect a combination of atelectasis and edema however infection should be considered in the appropriate setting.
AP portable semi upright view of the chest. Overlying EKG leads are noted. Previously noted right IJ central venous catheter is been removed. There has been interval improvement in pulmonary edema which appears nearly resolved. The heart remains mildly enlarged. No signs of pneumonia. No effusion or pneumothorax. Bony structures remain intact. As above.
Portable semi-upright radiograph of the chest demonstrates the interval placement of a right internal jugular venous catheter. The tip terminates in the region of the upper SVC. The remainder of the examination is stable. Right internal jugular venous catheter with tip terminating in the region of the upper SVC.
AP supine portable chest radiograph obtained. There is a left IJ central venous catheter with its tip in the expected level of the superior vena cava. There is opacity at the left lung base which could reflect consolidation and/or effusion. There is elevation of the right hemidiaphragm which appears chronic. There is associated right lung base atelectasis. No pneumothorax is seen. Heart size appears stable. Clips are noted in the right upper quadrant. Appropriately positioned left IJ central venous catheter. No evidence of complication. Left basal opacity likely consolidation with possible effusion.