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CTA CHEST / ABDOMEN / PELVISRadiologist dictatingIM 1150 / 1338
ImageTAAD Case 20 · Apache 2.0
Report ready
EXAM: CTA CHEST, ABDOMEN AND PELVIS (AORTIC DISSECTION PROTOCOL)
HISTORY: Chest pain.
TECHNIQUE: Arterial phase axial acquisition with multiplanar reformats and maximum intensity projection reconstructions. Dose reduction techniques utilized.
COMPARISON: CT chest 03/23/2025.
FINDINGS:
Aorta and branch vessels: Acute dissection arising at the aortic root, extending through the arch, all three major branch vessels, and the descending thoracic aorta. Stanford Type A. The aortic root is aneurysmal, measuring 7.0 cm.
Heart and pericardium: Small simple pericardial effusion. No hemopericardium.
Lungs and pleura: Bilateral lower lobe collapse. Trace simple pleural effusions. No hemothorax.
Mediastinum: No lymphadenopathy or mediastinal mass.
Abdomen and pelvis: Solid organs unremarkable. No free fluid or free air.
IMPRESSION:
1. Acute Stanford Type A aortic dissection arising at a 7.0 cm aneurysmal aortic root.
2. Urgent cardiothoracic surgery consultation recommended.
EXAM: CTA CHEST, ABDOMEN AND PELVIS (AORTIC DISSECTION PROTOCOL)
HISTORY: Chest pain.
TECHNIQUE: Arterial phase axial acquisition with multiplanar reformats and maximum intensity projection reconstructions. Dose reduction techniques utilized.
COMPARISON: CT chest 03/23/2025.
FINDINGS:
Aorta and branch vessels: Acute dissection arising at the aortic root, extending through the arch, all three major branch vessels, and the descending thoracic aorta. Stanford Type A. The aortic root is aneurysmal, measuring 7.0 cm.
Heart and pericardium: Small simple pericardial effusion. No hemopericardium.
Lungs and pleura: Bilateral lower lobe collapse. Trace simple pleural effusions. No hemothorax.
Mediastinum: No lymphadenopathy or mediastinal mass.
Abdomen and pelvis: Solid organs unremarkable. No free fluid or free air.
IMPRESSION:
1. Acute Stanford Type A aortic dissection arising at a 7.0 cm aneurysmal aortic root.
2. Urgent cardiothoracic surgery consultation recommended.
19.9s
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Dictation
Head CT. Bleed in the right frontal, 3.2 by 2.1 by 1.8 centimeters. No wait, by 2.4 by 2.0.
EXAM: CT HEAD WITHOUT CONTRAST
TECHNIQUE: Axial images of the brain without intravenous contrast.
COMPARISON: None.
FINDINGS:
Brain: Intraparenchymal hematoma in the right frontal lobe measuring 3.2 x 2.4 x 2.0 cm. No midline shift.
Extra-axial: No subarachnoid or subdural hemorrhage.
Ventricles: Normal in size and configuration.
Skull and sinuses: No acute fracture.
IMPRESSION: Intraparenchymal hematoma in the right frontal lobe measuring 3.2 x 2.4 x 2.0 cm.
7.6s
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Dictation
Portable chest. Left lower lobe pneumonia. Get CT with.
EXAM: PORTABLE CHEST RADIOGRAPH, 1 VIEW
TECHNIQUE: Single AP portable view of the chest.
COMPARISON: None.
FINDINGS:
Lungs: Consolidative opacity in the left lower lobe, consistent with pneumonia.
Pleura: No pleural effusion or pneumothorax.
Heart and mediastinum: Normal cardiomediastinal silhouette.
Bones and soft tissues: No acute osseous abnormality.
IMPRESSION: Left lower lobe pneumonia. Recommend CT chest with contrast.
5.8s
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Dictation
Gallstones, no wall thickening, negative Murphy's. CBD five millimeters.
Radiologist A
No template available·Succinct reporting style
EXAM: US ABDOMEN RUQ
TECHNIQUE: Grayscale and Doppler ultrasound of the right upper quadrant.
COMPARISON: None.
FINDINGS:
Liver: Normal.
Gallbladder: Gallstones. No wall thickening or pericholecystic fluid. Negative Murphy's.
Common bile duct: 5 mm.
Pancreas: Normal.
Right kidney: Normal echogenicity. No hydronephrosis.
IMPRESSION: Gallstones. No acute cholecystitis.
Radiologist B
Template available·[ ] template field·▾ picklist
EXAM: [LIMITED RIGHT UPPER QUADRANT ULTRASOUND]
TECHNIQUE: Grayscale sonographic evaluation of the right upper quadrant, supplemented with color and spectral Doppler as needed.
COMPARISON: [None.]
FINDINGS:
Liver: [Normal in size, contour, and echogenicity. Antegrade flow is demonstrated in the main portal vein.]
Gallbladder and bile ducts: [There are no gallstones, no gallbladder wall thickening or pericholecystic fluid. Negative sonographic Murphy's sign.] The common bile duct measures [ ] mm.
Pancreas: [The visualized portions are normal in appearance.]
IMPRESSION: [Normal abdominal ultrasound.]
EXAM: [LIMITED RIGHT UPPER QUADRANT ULTRASOUND]
TECHNIQUE: Grayscale sonographic evaluation of the right upper quadrant, supplemented with color and spectral Doppler as needed.
COMPARISON: [None.]
FINDINGS:
Liver: [Normal in size, contour, and echogenicity. Antegrade flow is demonstrated in the main portal vein.]
Gallbladder and bile ducts: [Mobile echogenic foci with posterior acoustic shadowing are present within the gallbladder lumen, consistent with cholelithiasis. There is no gallbladder wall thickening or pericholecystic fluid, and the sonographic Murphy's sign is negative.] The common bile duct measures [5] mm.
Pancreas: [The visualized portions are normal in appearance.]
IMPRESSION: [Cholelithiasis without sonographic evidence of acute cholecystitis. The common bile duct is within normal limits.]
5.5s
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Dictation
Right lower quadrant pain. No acute finding. Appendix normal. Triple A measures 3.5 centimeters. Left renal simple cyst.
EXAM: CT ABDOMEN AND PELVIS WITH CONTRAST
HISTORY: Right lower quadrant pain
TECHNIQUE: Axial computed tomography of the abdomen and pelvis with intravenous contrast.
COMPARISON: None.
FINDINGS:
Solid organs: Liver, gallbladder, spleen, pancreas and adrenal glands are normal.
Bowel: Normal appendix. No obstruction or inflammatory change.
Kidneys: Simple cyst in the left kidney. No follow-up imaging indicated.
Aorta: Abdominal aortic aneurysm measuring 3.5 cm.
Bladder and pelvic organs: Normal.
Peritoneum: No free fluid or free air.
Bones and soft tissues: No acute osseous abnormality.
IMPRESSION:
No acute abnormality. Normal appendix.
Abdominal aortic aneurysm measuring 3.5 cm. Recommend surveillance imaging in 3 years and vascular surgery consultation per Society for Vascular Surgery guidelines.
7.7s
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Dictation
Pain, increased LFTs. Gallbladder findings are non-specific, question of cholecystitis. Recommend HIDA. Steatohepatitis.
Sonographer worksheet
Arrives with the study
Technologist impression·superseded by dictation
Generated report
Findings merged
EXAM: US ABDOMEN RUQ LIMITED
HISTORY: Pain. Elevated liver function tests.
TECHNIQUE: Grayscale sonographic evaluation of the right upper quadrant supplemented with color and spectral Doppler as needed.
COMPARISON: None.
FINDINGS:
Liver: Hepatomegaly measuring 22.6 cm with hepatic steatosis and thickened main portal vein walls. Hepatopetal portal venous flow.
Gallbladder: Distended gallbladder with a 0.6 cm thickened, edematous wall and trace pericholecystic fluid. Intraluminal echoes without visible shadowing calculi. Positive sonographic Murphy's sign.
Common bile duct: 7.8 mm, dilated.
Right kidney: Measures 11.0 cm. Normal echogenicity. No hydronephrosis.
IMPRESSION:
Steatohepatitis.
Sonographic gallbladder findings are non-specific, possibly due to cholecystitis or hepatic parenchymal disease. Recommend HIDA scan for further evaluation.
Dilated common bile duct.
7.5s
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Dictation
Actually, possible mets include an 8 mm enhancing lesion in the pancreas body and a 4 mm solid nodule in the right lower lobe that I initially missed.
IMPRESSION:
Heterogeneous mass in the left renal upper pole measuring 5.6 cm, highly concerning for renal cell carcinoma.
No metastatic disease.
IMPRESSION:
Heterogeneous mass in the left renal upper pole measuring 5.6 cm, highly concerning for renal cell carcinoma.
8 mm enhancing lesion in the pancreatic body and 4 mm solid nodule in the right lower lobe. Concern for metastatic disease in the pancreas and lungs.
Recommend CT chest with contrast and MRI abdomen with and without contrast.
9.6s
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EXAM: MRI LUMBAR SPINE WITHOUT CONTRAST
HISTORY: Low back pain radiating to the left leg
TECHNIQUE: Multiplanar, multisequence magnetic resonance imaging of the lumbar spine without intravenous contrast.
COMPARISON: None.
FINDINGS:
Alignment: Normal. No spondylolisthesis.
Vertebral bodies: Normal marrow signal. No fracture.
Conus medullaris: Terminates at L1 and is normal.
L4-L5: Broad-based disc bulge with facet arthropathy and ligamentum flavum thickening, resulting in moderate spinal canal stenosis and moderate bilateral neural foraminal narrowing.
L5-S1: Left paracentral disc protrusion compresses the left S1 nerve root.
IMPRESSION:
Moderate spinal canal stenosis at L4-L5.
Left paracentral disc protrusion at L5-S1 compressing the traversing left S1 nerve root.
✓ SignedSigned by the radiologist
5.0s
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Bradford Bennett, MD
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Brad is a board-certified radiologist and the founder of Falcon Radiology, PLLC, an independent teleradiology practice. He completed his radiology residency at The Johns Hopkins Hospital and a neuroradiology fellowship at the Hospital of the University of Pennsylvania. After a year in private practice, he launched his own solo teleradiology company to gain greater flexibility, spend more time with his young family, and explore radiology-focused entrepreneurship. Dr. Bennett is passionate about improving radiologist workflow, promoting physician autonomy, and building sustainable, high-quality radiology practice models. He co-founded RadOverlay to address workflow inefficiencies common among teleradiologists.
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