ghazal-zamani/mimic_radio · Datasets at Hugging Face

real_id int64 0 8.12k	study_id int64 50M 60M	subject_id int64 10M 20M	findings stringlengths 12 1.44k ⌀	impression stringlengths 3 922 ⌀	frontal_lateral stringclasses 4 values
0	50,084,553	10,003,502	null	Compared to chest radiographs since ___, most recently ___. Large right and moderate left pleural effusions and severe bibasilar atelectasis are unchanged. Cardiac silhouette is obscured. No pneumothorax. Pulmonary edema is mild, obscured radiographically by overlying abnormalities.	AP
1	51,180,958	10,003,502	No evidence of consolidation to suggest pneumonia is seen. There is some retrocardiac atelectasis. A small left pleural effusion may be present. No pneumothorax is seen. No pulmonary edema. A right granuloma is unchanged. The heart is mildly enlarged, unchanged. There is tortuosity of the aorta.	null	AP
2	51,180,958	10,003,502	No evidence of consolidation to suggest pneumonia is seen. There is some retrocardiac atelectasis. A small left pleural effusion may be present. No pneumothorax is seen. No pulmonary edema. A right granuloma is unchanged. The heart is mildly enlarged, unchanged. There is tortuosity of the aorta.	null	LATERAL
3	52,139,270	10,003,502	There are moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Mild prominence of the interstitial markings suggests mild pulmonary edema. The cardiac silhouette is mildly enlarged. The mediastinal contours are unremarkable. There is no evidence of pneumothorax.	Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases.	LATERAL
4	52,139,270	10,003,502	There are moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Mild prominence of the interstitial markings suggests mild pulmonary edema. The cardiac silhouette is mildly enlarged. The mediastinal contours are unremarkable. There is no evidence of pneumothorax.	Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases.	AP
5	52,309,364	10,003,502	Moderate to large bilateral pleural effusions are again seen, likely right greater than left. There is suspected superimposed pulmonary edema may have slightly improved since prior although detailed evaluation is limited given layering pleural effusions. Vasculature appears less engorged. Cardiac silhouette cannot be assessed.	Mild to large bilateral, right greater than left pleural effusions. Degree of pulmonary edema may have slightly improved since prior exam although detailed evaluation is limited.	AP
6	53,282,957	10,003,502	Heart size is difficult to assess given the presence of moderate to large bilateral pleural effusions, but appears at least moderately enlarged. The mediastinal contours are grossly unremarkable. Perihilar haziness with vascular indistinctness and diffuse alveolar opacities are compatible with moderate pulmonary edema. Bibasilar compressive atelectasis is demonstrated. No pneumothorax is seen. Moderate multilevel degenerative changes are noted in the thoracic spine.	Moderate pulmonary edema with moderate to large bilateral pleural effusions and bibasilar atelectasis.	AP
7	53,836,463	10,003,502	The bilateral pleural effusions, lower lobe volume loss, and dense lower lobe opacity compatible with a combination of volume loss/infiltrate/effusion. The heart continues to be moderately enlarged. There is mild vascular redistribution.	CHF, slightly worse than on the prior study.	AP
8	57,641,661	10,003,502	Frontal and lateral views of the chest. Size of the bilateral effusions, left greater than right has slightly decreased in size since prior exam. There is less pulmonary vascular congestion on the current exam as well. Cardiac silhouette which appears enlarged, is unchanged. No acute osseous abnormality is detected.	Persistent small bilateral effusions, larger on the left which have decreased in size. Decreased pulmonary vascular congestion. No evidence of superimposed acute cardiopulmonary process.	LATERAL
9	57,641,661	10,003,502	Frontal and lateral views of the chest. Size of the bilateral effusions, left greater than right has slightly decreased in size since prior exam. There is less pulmonary vascular congestion on the current exam as well. Cardiac silhouette which appears enlarged, is unchanged. No acute osseous abnormality is detected.	Persistent small bilateral effusions, larger on the left which have decreased in size. Decreased pulmonary vascular congestion. No evidence of superimposed acute cardiopulmonary process.	AP
10	57,812,613	10,003,502	There is a moderate-sized left pleural effusion which is increased in size from the prior exam in ___. There is no right pleural effusion. The lungs are clear without pulmonary edema, consolidation, or pneumothorax. A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams. The cardiac size is mildly enlarged, unchanged from prior exams. Mediastinal contours are normal. The aorta is tortuous with mild calcifications. Degenerative changes of the lower thoracic and upper lumbar spine are unchanged.	1. Enlarging moderate left pleural effusion. 2. Stable right calcified granuloma. 3. Stable mild cardiomegaly.	LL
11	57,812,613	10,003,502	There is a moderate-sized left pleural effusion which is increased in size from the prior exam in ___. There is no right pleural effusion. The lungs are clear without pulmonary edema, consolidation, or pneumothorax. A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams. The cardiac size is mildly enlarged, unchanged from prior exams. Mediastinal contours are normal. The aorta is tortuous with mild calcifications. Degenerative changes of the lower thoracic and upper lumbar spine are unchanged.	1. Enlarging moderate left pleural effusion. 2. Stable right calcified granuloma. 3. Stable mild cardiomegaly.	PA
12	54,857,277	10,013,502	null	null	PA
13	54,857,277	10,013,502	null	null	PA
14	59,527,128	10,013,502	Low lung volumes, no pleural effusions. No parenchymal abnormality, in particular no evidence of pneumonia. Borderline size of the cardiac silhouette without pulmonary edema. No hilar or mediastinal abnormalities.	null	LL
15	59,527,128	10,013,502	Low lung volumes, no pleural effusions. No parenchymal abnormality, in particular no evidence of pneumonia. Borderline size of the cardiac silhouette without pulmonary edema. No hilar or mediastinal abnormalities.	null	PA
30	52,168,780	10,057,482	No previous images. There are relatively low lung volumes which may accentuate the prominent transverse diameter of the heart. No evidence of vascular congestion or pleural effusion. No convincing evidence of acute pneumonia, though there are some atelectatic changes at the left base.	null	LL
31	52,168,780	10,057,482	No previous images. There are relatively low lung volumes which may accentuate the prominent transverse diameter of the heart. No evidence of vascular congestion or pleural effusion. No convincing evidence of acute pneumonia, though there are some atelectatic changes at the left base.	null	null
32	50,281,931	10,072,167	As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.	null	LATERAL
33	50,281,931	10,072,167	As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.	null	PA
34	50,281,931	10,072,167	As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.	null	LATERAL
35	53,625,240	10,072,167	null	Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.	PA
36	53,625,240	10,072,167	null	Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.	LL
37	53,625,240	10,072,167	null	Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.	PA
38	53,950,117	10,072,167	Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.	No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.	PA
39	53,950,117	10,072,167	Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.	No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.	LATERAL
40	53,950,117	10,072,167	Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.	No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.	LATERAL
41	55,283,974	10,072,167	null	In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.	PA
42	55,283,974	10,072,167	null	In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.	LL
43	51,010,496	10,075,925	Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study. Mild cardiomegaly has increased compared with the immediate prior study. There is no pleural effusion, pneumothorax, or focal consolidation. The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable.	New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation.	PA
44	51,010,496	10,075,925	Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study. Mild cardiomegaly has increased compared with the immediate prior study. There is no pleural effusion, pneumothorax, or focal consolidation. The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable.	New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation.	LATERAL
45	51,856,263	10,174,198	Lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures.	No acute cardiopulmonary process.	PA
46	51,856,263	10,174,198	Lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures.	No acute cardiopulmonary process.	LATERAL
48	50,438,069	10,190,940	null	Comparison to ___. No relevant change. Minimally increased atelectasis at the left lung bases. Unchanged known elevation of the left hemidiaphragm and moderate cardiomegaly as well as signs of generalized fluid overload. No new focal parenchymal opacities. No evidence of pneumonia on the frontal and lateral radiograph.	PA
49	50,438,069	10,190,940	null	Comparison to ___. No relevant change. Minimally increased atelectasis at the left lung bases. Unchanged known elevation of the left hemidiaphragm and moderate cardiomegaly as well as signs of generalized fluid overload. No new focal parenchymal opacities. No evidence of pneumonia on the frontal and lateral radiograph.	LL
50	51,351,116	10,190,940	The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.	No evidence of pneumonia. No acute cardiopulmonary process.	PA
51	51,351,116	10,190,940	The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.	No evidence of pneumonia. No acute cardiopulmonary process.	LL
52	51,351,116	10,190,940	The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.	No evidence of pneumonia. No acute cardiopulmonary process.	PA
53	51,877,987	10,190,940	null	Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary edema or consolidation. Elevation of the left lung base posteriorly reflects scarring or linear atelectasis. There no findings to suggest acute chest syndrome or pneumonia and the cardiovascular findings could be chronic, but we have no priors studies with which to compare. A left central venous infusion pump catheter ends close to the superior cavoatrial junction.	LL
54	51,877,987	10,190,940	null	Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary edema or consolidation. Elevation of the left lung base posteriorly reflects scarring or linear atelectasis. There no findings to suggest acute chest syndrome or pneumonia and the cardiovascular findings could be chronic, but we have no priors studies with which to compare. A left central venous infusion pump catheter ends close to the superior cavoatrial junction.	PA
55	52,908,323	10,198,310	null	Cardiomegaly is severe, unchanged. Pacemaker leads are unchanged. There is interval progression of vascular congestion and interstitial pulmonary edema. No pneumothorax. No atelectasis. Subcutaneous air within the left chest wall is minimal.	LL
56	52,908,323	10,198,310	null	Cardiomegaly is severe, unchanged. Pacemaker leads are unchanged. There is interval progression of vascular congestion and interstitial pulmonary edema. No pneumothorax. No atelectasis. Subcutaneous air within the left chest wall is minimal.	AP
57	53,321,855	10,198,310	Lungs are fully expanded and clear. No pleural abnormalities. Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged. Pacemaker and ICD leads are unchanged in position. No evidence of displaced rib fracture.	No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position.	PA
58	53,321,855	10,198,310	Lungs are fully expanded and clear. No pleural abnormalities. Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged. Pacemaker and ICD leads are unchanged in position. No evidence of displaced rib fracture.	No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position.	LATERAL
59	54,296,371	10,198,310	null	Comparison to ___. The pacemaker leads are in correct position. No complications, notably no pneumothorax. Stable moderate cardiomegaly. Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis. No pneumothorax. No larger pleural effusions.	LL
60	54,296,371	10,198,310	null	Comparison to ___. The pacemaker leads are in correct position. No complications, notably no pneumothorax. Stable moderate cardiomegaly. Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis. No pneumothorax. No larger pleural effusions.	PA
61	55,018,013	10,198,310	null	Compared to chest radiographs since ___, most recently ___ and postoperative radiographs ___. Since ___, pulmonary vascular congestion has improved, mild pulmonary edema has resolved, but severe cardiomegaly is stable. Pleural effusions are small if any. No pneumothorax. 3 transvenous atrioventricular pacer leads, at least 2 of which are or found are unchanged in their respective positions since ___. 2 new epicardial leads project over the left heart border. New left pleural thickening partially hidden by the new left pectoral generator is a probably a small amount of bleeding associated with lead placement. There is no mediastinal widening or pneumothorax. Lungs are low in volume but clear of any focal abnormality.	AP
62	57,420,501	10,198,310	PA and lateral views of the chest provided. Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle. The heart is moderately enlarged. Hila appearing or urged. There is no overt pulmonary edema. No large effusion or pneumothorax. No focal consolidation concerning for pneumonia. The mediastinal contour is stable. Bony structures are intact. No free air below the right hemidiaphragm seen.	Moderate cardiomegaly with pulmonary vascular congestion.	LATERAL
63	57,420,501	10,198,310	PA and lateral views of the chest provided. Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle. The heart is moderately enlarged. Hila appearing or urged. There is no overt pulmonary edema. No large effusion or pneumothorax. No focal consolidation concerning for pneumonia. The mediastinal contour is stable. Bony structures are intact. No free air below the right hemidiaphragm seen.	Moderate cardiomegaly with pulmonary vascular congestion.	PA
64	59,538,225	10,198,310	null	In comparison with the study of ___, there appears to be a new pacer generator in place with what appear to be epicardial leads in the region of the left ventricle. No evidence of post procedure pneumothorax. There are lower lung volumes that may be accentuating the pulmonary vascularity.	AP
65	51,438,218	10,199,765	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.	PA
66	51,438,218	10,199,765	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.	LATERAL
67	51,438,218	10,199,765	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.	Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.	LATERAL
68	56,226,668	10,199,765	null	No relevant change as compared to the previous image. Moderate cardiomegaly. Mild central enlargement of the pulmonary arteries. No pleural effusions. No parenchymal opacities. No pneumothorax.	AP
69	56,874,598	10,199,765	null	As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly. Mild tortuosity of the descending aorta. No pleural effusions. No pneumonia, no pulmonary edema.	AP
70	58,927,269	10,244,947	AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.	No acute intrathoracic process.	LATERAL
71	58,927,269	10,244,947	AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.	No acute intrathoracic process.	AP
72	51,023,457	10,248,673	No focal consolidation is seen. There is elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view. No evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the spine. No displaced fracture is seen.	Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view.	PA
73	51,023,457	10,248,673	No focal consolidation is seen. There is elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view. No evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the spine. No displaced fracture is seen.	Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view.	LATERAL
74	55,182,796	10,248,673	null	1. Interval extubation. Right internal jugular central line and left basilar chest tube remain in place. Lung volumes are lower on the current examination. There is patchy opacity at the left base with an associated effusion, likely reflecting compressive atelectasis. No evidence of pulmonary edema. Cardiac and mediastinal contours are difficult to assess due to the low lung volumes and patient rotation on the current study, although the mediastinal contours are likely unchanged. Status post median sternotomy for CABG. No pneumothorax.	AP
75	55,680,175	10,248,673	null	1. Interval removal of the left chest tube. No evidence of pneumothorax. Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction, unchanged. Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. There is elevation of the left hemidiaphragm with some adjacent streaky opacities, suggestive of atelectasis. Blunting of the left costophrenic angle likely reflects a small effusion. There is also possibly a tiny right pleural effusion. No evidence of pulmonary edema.	AP
76	57,975,666	10,248,673	In comparison with the study of ___, there is continued opacification at the left base most likely reflecting pleural effusion and volume loss in the lower lobe. Mild blunting of the right costophrenic angle persists. No evidence of vascular congestion. Right IJ catheter remains in place.	null	null
77	57,975,666	10,248,673	In comparison with the study of ___, there is continued opacification at the left base most likely reflecting pleural effusion and volume loss in the lower lobe. Mild blunting of the right costophrenic angle persists. No evidence of vascular congestion. Right IJ catheter remains in place.	null	LL
78	57,118,642	10,253,119	The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.	No acute cardiopulmonary process.	AP
79	57,118,642	10,253,119	The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.	No acute cardiopulmonary process.	LATERAL
80	57,118,642	10,253,119	The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.	No acute cardiopulmonary process.	LATERAL
81	54,512,270	10,261,230	No previous studies for comparison. The heart size is within normal limits. Lungs are grossly clear without definite consolidation, pleural effusions, or signs for acute pulmonary edema. There are no pneumothoraces.	null	AP
117	53,799,929	10,269,181	The lungs are clear without consolidation or edema. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.	No acute pulmonary process.	PA
118	53,799,929	10,269,181	The lungs are clear without consolidation or edema. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.	No acute pulmonary process.	LATERAL
130	58,092,224	10,287,742	null	As compared to ___, there is unchanged evidence of mildly displaced right rib fractures. The right pneumothorax. Visualized on the CT examination from ___, is not visualized on the radiograph. No pleural effusions. No pulmonary edema. No pneumonia.	AP
131	59,266,404	10,295,064	PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.	No acute cardiopulmonary process.	LATERAL
132	59,266,404	10,295,064	PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.	No acute cardiopulmonary process.	PA
133	59,266,404	10,295,064	PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.	No acute cardiopulmonary process.	PA
137	52,139,824	10,308,375	null	The heart remains enlarged. There is opacity along the medial left hemidiaphragm, which is known to correspond to a Bochdalek's hernia containing portion of the left kidney. The right Bochdalek hernia is not as well visualized on today's examination. There is patchy bibasilar opacity with likely associated layering effusions. These findings could reflect compressive atelectasis, although aspiration pneumonia should also be considered. There is also an asymmetric airspace process involving the left apex, which likely is not significantly changed dating all the way back to ___ and therefore would favor a benign process. No pulmonary edema. No pneumothoraces. Mediastinal contours are stable.	AP
138	55,091,382	10,308,375	Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality.	1. Interval increase in moderate-sized right pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.	AP
139	57,023,953	10,308,375	Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.	Right lower lobe pneumonia. Small bilateral pleural effusions.	LATERAL
140	57,023,953	10,308,375	Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.	Right lower lobe pneumonia. Small bilateral pleural effusions.	PA
141	50,223,793	10,337,896	Allowing for differences in technique and projection, there has been minimal change in the appearance of the chest except for apparent slight increase in bilateral pleural effusions, now moderate on the right and small to moderate on the left.	null	AP
142	50,519,407	10,337,896	AP portable upright view of the chest. Extensive intrathoracic calcifications are again seen, better localized on the chest CT examination from ___. The heart size is top normal. A tracheostomy tube is appropriately positioned. A right PICC terminates at the caval atrial junction. Again seen are bilateral pulmonary parenchymal opacities, with interval improvement along the right mid and lower zones since the ___ radiograph. Opacities across the left lung are unchanged. There is no pneumothorax. Small bilateral pleural effusions are stable. ,	Interval decrease of right pulmonary parenchymal opacities, reflecting improvement since ___. Unchanged small bilateral pleural effusions.	AP
143	50,880,103	10,337,896	null	Findings on the chest CT ___ showed probable multi focal pneumonia, predominantly in the right lung, and mild interstitial edema. Edema improved between ___ and ___, and then opacification in the right lung increased again accompanied by increasing moderate right pleural effusion. The progression of these associated findings this suggested that the interval change was primarily due to cardiac decompensation. Today edema has worsened in both lungs, and the moderate right pleural effusion is larger, although the opacification in the left lower lung is heterogeneous enough to suggest concurrent pneumonia or large scale aspiration. . Mild cardiomegaly and chronic mediastinal widening are chronic.	AP
144	53,275,640	10,337,896	The tracheostomy tube is unchanged in position and terminates approximately 4.8 cm above the carina. The right PICC line terminates in the distal SVC. There is no significant change in the lungs when compared to ___. There are several parenchymal calcifications which were characterized on the most recent CT scan. Again noted are diffuse infiltrative parenchymal opacities, right worse than left; this is largely due to pulmonary edema and the right-sided pleural effusion, but underlying pneumonia cannot be excluded. The mediastinum is wide, which was noted as far back as the outside hospital CXR from ___. No acute osseous abnormalities.	1. Moderate pulmonary edema, unchanged. 2. Interval improvement in right-sided pleural effusion.	AP
145	53,323,373	10,337,896	null	In comparison with the study of ___, there is little change. Diffuse bilateral pulmonary opacification with areas of calcificationpersist with bilateral pleural effusions and no change in the monitoring and support devices.	AP
146	53,482,443	10,337,896	null	Endotracheal tube and right internal jugular central line are unchanged position. Nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified. Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection. Given the extensive parenchymal abnormality, this does limit the sensitivity of plain radiography. Bilateral apical pleural thickening, left greater than right, which is unchanged. There are stable bilateral layering effusions, left greater than right, with probable associated compressive atelectasis in the lower lobes. No overt pulmonary edema. Heart remains stably enlarged. Bilateral glenohumeral degenerative changes with deformity of the left humeral head.	AP
147	53,778,461	10,337,896	Multiple calcified pulmonary nodules and calcified lymph nodes within the neck. Severe degenerative changes of the glenohumeral joints. Bilateral pleural effusions with bibasilar atelectasis. Developing bibasilar consolidation is difficult to exclude. No pneumothorax.	Small bilateral pleural effusions with passive atelectasis. Developing bibasilar consolidations are difficult to exclude. Redemonstrated densities within the lung parenchyma and neck, possibly secondary to prior granulomatous disease.	AP
148	53,799,148	10,337,896	null	Interval placement of an endotracheal tube which has its tip approximately 4.5 cm above the carina. Nasogastric tube appears to be coursing below the diaphragm with the tip not identified. Right internal jugular central line is unchanged in position. Overall stable cardiac mediastinal contours. No interval change in the bilateral multiple calcified lymph nodes and parenchymal and pleural opacities. Unchanged layering bilateral effusions. Asymmetric biapical pleural thickening, left greater than right, all is unchanged dating back to ___. No pneumothorax.	AP
149	54,031,658	10,337,896	null	As compared to the previous radiograph, the parenchymal opacities ___ notably on the left, have moderately decreased in severity. The monitoring and support devices are unchanged. Unchanged moderate cardiomegaly. Unchanged known intra and extra thoracic lymph node calcifications.	AP
150	54,346,165	10,337,896	AP portable semi upright view of the chest. Multiple calcified lymph nodes again seen projecting over the chest and neck. The previously noted tracheostomy tube is no longer seen. Calcified pleural plaque along the right hemidiaphragm noted along with multiple bilateral calcified pulmonary nodules. A small right pleural effusion is likely present. No convincing signs of pneumonia. The cardiomediastinal silhouette appears grossly within normal limits. Severe degenerative disease at both shoulders is again noted.	No convincing evidence for pneumonia. Chronic changes as detailed above.	AP
151	54,785,280	10,337,896	An ET tube is present approximately 3.6 cm above the carina. The enteric tube is present the distal tip off the film. There is no pneumothorax. There are small bilateral effusions. Dense calcified opacities in both upper lung fields and hila are noted, consistent with prior history of tuberculosis. Atelectasis or consolidation of the lung bases are noted. Reticular changes are also noted, which may be acute or chronic.	null	AP
152	54,966,187	10,337,896	null	In comparison with the study of ___, there is little change. Monitoring and support devices remain in place. Diffuse bilateral pulmonary opacifications persist along with multiple dense calcifications.	AP
153	55,022,783	10,337,896	null	In comparison with the earlier study of this day, the monitoring and support devices are unchanged diffuse pulmonary opacification is processed and may be more prominent in the left base, suggesting some layering pleural effusion. .	AP
154	55,070,875	10,337,896	The NG tube not well visualized, but may pass into the abdomen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are in stable position from prior exam.	NG tube not well visualized, but may pass into the abdomen. If it is a better visualization is desired, repeat radiographs with abdominal technique can be performed.	AP
155	55,070,875	10,337,896	The NG tube not well visualized, but may pass into the abdomen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are in stable position from prior exam.	NG tube not well visualized, but may pass into the abdomen. If it is a better visualization is desired, repeat radiographs with abdominal technique can be performed.	AP
156	55,705,635	10,337,896	null	Minimal interval improvement of the pre-existing right pleural effusion, with subsequent increase in transparency of the right lung base. In the interval, the nasogastric tube has been removed. No other relevant changes.	AP
157	55,929,666	10,337,896	null	Endotracheal tube continues to have its tip approximately 4 cm above the carina. A right internal jugular central line is unchanged in position. Nasogastric tube appears to have pulled back into the mid esophagus. No interval change in appearance of the multiple calcified nodes, multiple calcified pleural plaques, and multiple calcified parenchymal opacities. Layering effusions with retrocardiac opacity likely reflecting compressive atelectasis. No pneumothorax. Asymmetric biapical pleural thickening unchanged. Bilateral humeral head degenerative changes with remodeling on the left.	AP
158	56,165,736	10,337,896	null	As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload. No other changes. The multiple known calcifications are constant in appearance. In the interval, the patient has received a tracheostomy tube. There is no pneumothorax.	AP
159	56,165,736	10,337,896	null	As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload. No other changes. The multiple known calcifications are constant in appearance. In the interval, the patient has received a tracheostomy tube. There is no pneumothorax.	AP
160	56,271,118	10,337,896	There is an ET tube which terminates 3.3 cm above the carina. The right IJ central venous catheter is in stable position with tip projecting over the low SVC. Again seen is an enteric tube with distal tip projecting below the lower limit of film, not visualized. Allowing for changes in differences in rotation, the cardiomediastinal silhouette is unchanged. The bilateral hila are not well visualized. There is again seen pulmonary vascular congestion and moderate pulmonary edema, possibly worsened in the left lung in comparison to prior radiograph. There is stable pleural thickening most notable in the left apex. There are at least small bilateral layering pleural effusions, stable in size. There is unchanged appearance of multiple bilateral calcified lymph nodes as well as pleural and parenchymal calcifications. There is no pneumothorax.	Moderate pulmonary edema, possibly worse in the left lung most prominently. Otherwise stable chest x-ray.	AP
161	56,329,890	10,337,896	ET tube is seen in stable position 3.7 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however side port is most likely above the GE junction, in comparison to prior radiograph. The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well seen. There is unchanged appearance of the bilateral lung parenchyma, with pulmonary vascular congestion and moderate pulmonary edema. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications. There is no pneumothorax.	1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.	AP
162	56,329,890	10,337,896	ET tube is seen in stable position 3.7 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however side port is most likely above the GE junction, in comparison to prior radiograph. The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well seen. There is unchanged appearance of the bilateral lung parenchyma, with pulmonary vascular congestion and moderate pulmonary edema. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications. There is no pneumothorax.	1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.	AP
163	56,437,767	10,337,896	There has been interval placement of a right internal jugular line with tip terminating in the lower SVC. There is no pneumothorax. There is no improvement in the lung fields since the recent prior study.	null	AP

0

50,084,553

10,003,502

null

Compared to chest radiographs since ___, most recently ___. Large right and moderate left pleural effusions and severe bibasilar atelectasis are unchanged. Cardiac silhouette is obscured. No pneumothorax. Pulmonary edema is mild, obscured radiographically by overlying abnormalities.

AP

1

51,180,958

10,003,502

No evidence of consolidation to suggest pneumonia is seen. There is some retrocardiac atelectasis. A small left pleural effusion may be present. No pneumothorax is seen. No pulmonary edema. A right granuloma is unchanged. The heart is mildly enlarged, unchanged. There is tortuosity of the aorta.

null

AP

2

51,180,958

10,003,502

No evidence of consolidation to suggest pneumonia is seen. There is some retrocardiac atelectasis. A small left pleural effusion may be present. No pneumothorax is seen. No pulmonary edema. A right granuloma is unchanged. The heart is mildly enlarged, unchanged. There is tortuosity of the aorta.

null

LATERAL

3

52,139,270

10,003,502

There are moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Mild prominence of the interstitial markings suggests mild pulmonary edema. The cardiac silhouette is mildly enlarged. The mediastinal contours are unremarkable. There is no evidence of pneumothorax.

Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases.

LATERAL

4

52,139,270

10,003,502

There are moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Mild prominence of the interstitial markings suggests mild pulmonary edema. The cardiac silhouette is mildly enlarged. The mediastinal contours are unremarkable. There is no evidence of pneumothorax.

Bilateral pleural effusions, cardiomegaly and mild edema suggest fluid overload, however, given the clinical history, underlying consolidation due to pneumonia cannot be excluded at the lung bases.

AP

5

52,309,364

10,003,502

Moderate to large bilateral pleural effusions are again seen, likely right greater than left. There is suspected superimposed pulmonary edema may have slightly improved since prior although detailed evaluation is limited given layering pleural effusions. Vasculature appears less engorged. Cardiac silhouette cannot be assessed.

Mild to large bilateral, right greater than left pleural effusions. Degree of pulmonary edema may have slightly improved since prior exam although detailed evaluation is limited.

AP

6

53,282,957

10,003,502

Heart size is difficult to assess given the presence of moderate to large bilateral pleural effusions, but appears at least moderately enlarged. The mediastinal contours are grossly unremarkable. Perihilar haziness with vascular indistinctness and diffuse alveolar opacities are compatible with moderate pulmonary edema. Bibasilar compressive atelectasis is demonstrated. No pneumothorax is seen. Moderate multilevel degenerative changes are noted in the thoracic spine.

Moderate pulmonary edema with moderate to large bilateral pleural effusions and bibasilar atelectasis.

AP

7

53,836,463

10,003,502

The bilateral pleural effusions, lower lobe volume loss, and dense lower lobe opacity compatible with a combination of volume loss/infiltrate/effusion. The heart continues to be moderately enlarged. There is mild vascular redistribution.

CHF, slightly worse than on the prior study.

AP

8

57,641,661

10,003,502

Frontal and lateral views of the chest. Size of the bilateral effusions, left greater than right has slightly decreased in size since prior exam. There is less pulmonary vascular congestion on the current exam as well. Cardiac silhouette which appears enlarged, is unchanged. No acute osseous abnormality is detected.

Persistent small bilateral effusions, larger on the left which have decreased in size. Decreased pulmonary vascular congestion. No evidence of superimposed acute cardiopulmonary process.

LATERAL

9

57,641,661

10,003,502

Frontal and lateral views of the chest. Size of the bilateral effusions, left greater than right has slightly decreased in size since prior exam. There is less pulmonary vascular congestion on the current exam as well. Cardiac silhouette which appears enlarged, is unchanged. No acute osseous abnormality is detected.

Persistent small bilateral effusions, larger on the left which have decreased in size. Decreased pulmonary vascular congestion. No evidence of superimposed acute cardiopulmonary process.

AP

10

57,812,613

10,003,502

There is a moderate-sized left pleural effusion which is increased in size from the prior exam in ___. There is no right pleural effusion. The lungs are clear without pulmonary edema, consolidation, or pneumothorax. A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams. The cardiac size is mildly enlarged, unchanged from prior exams. Mediastinal contours are normal. The aorta is tortuous with mild calcifications. Degenerative changes of the lower thoracic and upper lumbar spine are unchanged.

1. Enlarging moderate left pleural effusion. 2. Stable right calcified granuloma. 3. Stable mild cardiomegaly.

LL

11

57,812,613

10,003,502

There is a moderate-sized left pleural effusion which is increased in size from the prior exam in ___. There is no right pleural effusion. The lungs are clear without pulmonary edema, consolidation, or pneumothorax. A small calcified granuloma in the right mid-to-lower lung zone is unchanged from prior exams. The cardiac size is mildly enlarged, unchanged from prior exams. Mediastinal contours are normal. The aorta is tortuous with mild calcifications. Degenerative changes of the lower thoracic and upper lumbar spine are unchanged.

1. Enlarging moderate left pleural effusion. 2. Stable right calcified granuloma. 3. Stable mild cardiomegaly.

PA

12

54,857,277

10,013,502

null

PA

13

54,857,277

10,013,502

null

PA

14

59,527,128

10,013,502

Low lung volumes, no pleural effusions. No parenchymal abnormality, in particular no evidence of pneumonia. Borderline size of the cardiac silhouette without pulmonary edema. No hilar or mediastinal abnormalities.

null

LL

15

59,527,128

10,013,502

Low lung volumes, no pleural effusions. No parenchymal abnormality, in particular no evidence of pneumonia. Borderline size of the cardiac silhouette without pulmonary edema. No hilar or mediastinal abnormalities.

null

PA

30

52,168,780

10,057,482

No previous images. There are relatively low lung volumes which may accentuate the prominent transverse diameter of the heart. No evidence of vascular congestion or pleural effusion. No convincing evidence of acute pneumonia, though there are some atelectatic changes at the left base.

null

LL

31

52,168,780

10,057,482

No previous images. There are relatively low lung volumes which may accentuate the prominent transverse diameter of the heart. No evidence of vascular congestion or pleural effusion. No convincing evidence of acute pneumonia, though there are some atelectatic changes at the left base.

null

32

50,281,931

10,072,167

As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.

null

LATERAL

33

50,281,931

10,072,167

As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.

null

PA

34

50,281,931

10,072,167

As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal scarring at the lateral aspects of the right lung. No lung nodules or masses suggesting metastatic disease. No pleural effusions. No diffuse or focal lung parenchymal disease.

null

LATERAL

35

53,625,240

10,072,167

null

Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.

PA

36

53,625,240

10,072,167

null

Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.

LL

37

53,625,240

10,072,167

null

Heart size is normal. Aorta is tortuous. Lungs are clear. There is no pleural effusion or pneumothorax.

PA

38

53,950,117

10,072,167

Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.

No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.

PA

39

53,950,117

10,072,167

Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.

No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.

LATERAL

40

53,950,117

10,072,167

Heart size is normal. Aorta is tortuous. Decrease in lung volume. However, the Lungs are clear. There is no pleural effusion or pneumothorax.

No evidence of metastatic disease in the thorax, within the limitations of chsst radiograph.

LATERAL

41

55,283,974

10,072,167

null

In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.

PA

42

55,283,974

10,072,167

null

In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Specifically, at the limits of plain radiography, there is no evidence of pulmonary or skeletal metastasis.

LL

43

51,010,496

10,075,925

Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study. Mild cardiomegaly has increased compared with the immediate prior study. There is no pleural effusion, pneumothorax, or focal consolidation. The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable.

New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation.

PA

44

51,010,496

10,075,925

Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study. Mild cardiomegaly has increased compared with the immediate prior study. There is no pleural effusion, pneumothorax, or focal consolidation. The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable.

New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation.

LATERAL

45

51,856,263

10,174,198

Lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures.

No acute cardiopulmonary process.

PA

46

51,856,263

10,174,198

Lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures.

No acute cardiopulmonary process.

LATERAL

48

50,438,069

10,190,940

null

Comparison to ___. No relevant change. Minimally increased atelectasis at the left lung bases. Unchanged known elevation of the left hemidiaphragm and moderate cardiomegaly as well as signs of generalized fluid overload. No new focal parenchymal opacities. No evidence of pneumonia on the frontal and lateral radiograph.

PA

49

50,438,069

10,190,940

null

Comparison to ___. No relevant change. Minimally increased atelectasis at the left lung bases. Unchanged known elevation of the left hemidiaphragm and moderate cardiomegaly as well as signs of generalized fluid overload. No new focal parenchymal opacities. No evidence of pneumonia on the frontal and lateral radiograph.

LL

50

51,351,116

10,190,940

The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.

No evidence of pneumonia. No acute cardiopulmonary process.

PA

51

51,351,116

10,190,940

The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.

No evidence of pneumonia. No acute cardiopulmonary process.

LL

52

51,351,116

10,190,940

The left hemidiaphragm is elevated. Cardiomegaly is stable. There is bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The left-sided port terminates at the distal SVC.

No evidence of pneumonia. No acute cardiopulmonary process.

PA

53

51,877,987

10,190,940

null

Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary edema or consolidation. Elevation of the left lung base posteriorly reflects scarring or linear atelectasis. There no findings to suggest acute chest syndrome or pneumonia and the cardiovascular findings could be chronic, but we have no priors studies with which to compare. A left central venous infusion pump catheter ends close to the superior cavoatrial junction.

LL

54

51,877,987

10,190,940

null

Moderate cardiomegaly is accompanied by pulmonary and mediastinal vascular engorgement but no pulmonary edema or consolidation. Elevation of the left lung base posteriorly reflects scarring or linear atelectasis. There no findings to suggest acute chest syndrome or pneumonia and the cardiovascular findings could be chronic, but we have no priors studies with which to compare. A left central venous infusion pump catheter ends close to the superior cavoatrial junction.

PA

55

52,908,323

10,198,310

null

Cardiomegaly is severe, unchanged. Pacemaker leads are unchanged. There is interval progression of vascular congestion and interstitial pulmonary edema. No pneumothorax. No atelectasis. Subcutaneous air within the left chest wall is minimal.

LL

56

52,908,323

10,198,310

null

Cardiomegaly is severe, unchanged. Pacemaker leads are unchanged. There is interval progression of vascular congestion and interstitial pulmonary edema. No pneumothorax. No atelectasis. Subcutaneous air within the left chest wall is minimal.

AP

57

53,321,855

10,198,310

Lungs are fully expanded and clear. No pleural abnormalities. Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged. Pacemaker and ICD leads are unchanged in position. No evidence of displaced rib fracture.

No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position.

PA

58

53,321,855

10,198,310

Lungs are fully expanded and clear. No pleural abnormalities. Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged. Pacemaker and ICD leads are unchanged in position. No evidence of displaced rib fracture.

No evidence of rib fracture. Pacemaker and ICD leads are unchanged in position.

LATERAL

59

54,296,371

10,198,310

null

Comparison to ___. The pacemaker leads are in correct position. No complications, notably no pneumothorax. Stable moderate cardiomegaly. Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis. No pneumothorax. No larger pleural effusions.

LL

60

54,296,371

10,198,310

null

Comparison to ___. The pacemaker leads are in correct position. No complications, notably no pneumothorax. Stable moderate cardiomegaly. Stable mild elongation of the descending aorta and minimal retrocardiac atelectasis. No pneumothorax. No larger pleural effusions.

PA

61

55,018,013

10,198,310

null

Compared to chest radiographs since ___, most recently ___ and postoperative radiographs ___. Since ___, pulmonary vascular congestion has improved, mild pulmonary edema has resolved, but severe cardiomegaly is stable. Pleural effusions are small if any. No pneumothorax. 3 transvenous atrioventricular pacer leads, at least 2 of which are or found are unchanged in their respective positions since ___. 2 new epicardial leads project over the left heart border. New left pleural thickening partially hidden by the new left pectoral generator is a probably a small amount of bleeding associated with lead placement. There is no mediastinal widening or pneumothorax. Lungs are low in volume but clear of any focal abnormality.

AP

62

57,420,501

10,198,310

PA and lateral views of the chest provided. Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle. The heart is moderately enlarged. Hila appearing or urged. There is no overt pulmonary edema. No large effusion or pneumothorax. No focal consolidation concerning for pneumonia. The mediastinal contour is stable. Bony structures are intact. No free air below the right hemidiaphragm seen.

Moderate cardiomegaly with pulmonary vascular congestion.

LATERAL

63

57,420,501

10,198,310

PA and lateral views of the chest provided. Left chest wall AICD is again seen with leads extending into the right atrium and right ventricle. The heart is moderately enlarged. Hila appearing or urged. There is no overt pulmonary edema. No large effusion or pneumothorax. No focal consolidation concerning for pneumonia. The mediastinal contour is stable. Bony structures are intact. No free air below the right hemidiaphragm seen.

Moderate cardiomegaly with pulmonary vascular congestion.

PA

64

59,538,225

10,198,310

null

In comparison with the study of ___, there appears to be a new pacer generator in place with what appear to be epicardial leads in the region of the left ventricle. No evidence of post procedure pneumothorax. There are lower lung volumes that may be accentuating the pulmonary vascularity.

AP

65

51,438,218

10,199,765

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.

PA

66

51,438,218

10,199,765

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.

LATERAL

67

51,438,218

10,199,765

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation. No focal consolidation seen elsewhere. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No overt pulmonary edema is seen. Chronic changes at the right acromioclavicular joint are not well assessed.

Subtle patchy opacity along the left heart border on the frontal view, not substantiated on the lateral view, may be due to atelectasis/ scarring or epicardial fat pad, less likely consolidation.

LATERAL

68

56,226,668

10,199,765

null

No relevant change as compared to the previous image. Moderate cardiomegaly. Mild central enlargement of the pulmonary arteries. No pleural effusions. No parenchymal opacities. No pneumothorax.

AP

69

56,874,598

10,199,765

null

As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly. Mild tortuosity of the descending aorta. No pleural effusions. No pneumonia, no pulmonary edema.

AP

70

58,927,269

10,244,947

AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

No acute intrathoracic process.

LATERAL

71

58,927,269

10,244,947

AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

No acute intrathoracic process.

AP

72

51,023,457

10,248,673

No focal consolidation is seen. There is elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view. No evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the spine. No displaced fracture is seen.

Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view.

PA

73

51,023,457

10,248,673

No focal consolidation is seen. There is elevation of the mid to posterior left hemidiaphragm with minimal blunting of the left costophrenic angle without a definite pleural effusion seen on the lateral view. No evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the spine. No displaced fracture is seen.

Elevated left hemidiaphragm and blunting of the left costophrenic angle although no definite evidence of pleural effusion seen on the lateral view.

LATERAL

74

55,182,796

10,248,673

null

1. Interval extubation. Right internal jugular central line and left basilar chest tube remain in place. Lung volumes are lower on the current examination. There is patchy opacity at the left base with an associated effusion, likely reflecting compressive atelectasis. No evidence of pulmonary edema. Cardiac and mediastinal contours are difficult to assess due to the low lung volumes and patient rotation on the current study, although the mediastinal contours are likely unchanged. Status post median sternotomy for CABG. No pneumothorax.

AP

75

55,680,175

10,248,673

null

1. Interval removal of the left chest tube. No evidence of pneumothorax. Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction, unchanged. Status post median sternotomy for CABG with stable postoperative cardiac and mediastinal contours. There is elevation of the left hemidiaphragm with some adjacent streaky opacities, suggestive of atelectasis. Blunting of the left costophrenic angle likely reflects a small effusion. There is also possibly a tiny right pleural effusion. No evidence of pulmonary edema.

AP

76

57,975,666

10,248,673

In comparison with the study of ___, there is continued opacification at the left base most likely reflecting pleural effusion and volume loss in the lower lobe. Mild blunting of the right costophrenic angle persists. No evidence of vascular congestion. Right IJ catheter remains in place.

null

77

57,975,666

10,248,673

In comparison with the study of ___, there is continued opacification at the left base most likely reflecting pleural effusion and volume loss in the lower lobe. Mild blunting of the right costophrenic angle persists. No evidence of vascular congestion. Right IJ catheter remains in place.

null

LL

78

57,118,642

10,253,119

The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

No acute cardiopulmonary process.

AP

79

57,118,642

10,253,119

The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

No acute cardiopulmonary process.

LATERAL

80

57,118,642

10,253,119

The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

No acute cardiopulmonary process.

LATERAL

81

54,512,270

10,261,230

No previous studies for comparison. The heart size is within normal limits. Lungs are grossly clear without definite consolidation, pleural effusions, or signs for acute pulmonary edema. There are no pneumothoraces.

null

AP

117

53,799,929

10,269,181

The lungs are clear without consolidation or edema. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.

No acute pulmonary process.

PA

118

53,799,929

10,269,181

The lungs are clear without consolidation or edema. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.

No acute pulmonary process.

LATERAL

130

58,092,224

10,287,742

null

As compared to ___, there is unchanged evidence of mildly displaced right rib fractures. The right pneumothorax. Visualized on the CT examination from ___, is not visualized on the radiograph. No pleural effusions. No pulmonary edema. No pneumonia.

AP

131

59,266,404

10,295,064

PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.

No acute cardiopulmonary process.

LATERAL

132

59,266,404

10,295,064

PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.

No acute cardiopulmonary process.

PA

133

59,266,404

10,295,064

PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable.

No acute cardiopulmonary process.

PA

137

52,139,824

10,308,375

null

The heart remains enlarged. There is opacity along the medial left hemidiaphragm, which is known to correspond to a Bochdalek's hernia containing portion of the left kidney. The right Bochdalek hernia is not as well visualized on today's examination. There is patchy bibasilar opacity with likely associated layering effusions. These findings could reflect compressive atelectasis, although aspiration pneumonia should also be considered. There is also an asymmetric airspace process involving the left apex, which likely is not significantly changed dating all the way back to ___ and therefore would favor a benign process. No pulmonary edema. No pneumothoraces. Mediastinal contours are stable.

AP

138

55,091,382

10,308,375

Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality.

1. Interval increase in moderate-sized right pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.

AP

139

57,023,953

10,308,375

Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.

Right lower lobe pneumonia. Small bilateral pleural effusions.

LATERAL

140

57,023,953

10,308,375

Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.

Right lower lobe pneumonia. Small bilateral pleural effusions.

PA

141

50,223,793

10,337,896

Allowing for differences in technique and projection, there has been minimal change in the appearance of the chest except for apparent slight increase in bilateral pleural effusions, now moderate on the right and small to moderate on the left.

null

AP

142

50,519,407

10,337,896

AP portable upright view of the chest. Extensive intrathoracic calcifications are again seen, better localized on the chest CT examination from ___. The heart size is top normal. A tracheostomy tube is appropriately positioned. A right PICC terminates at the caval atrial junction. Again seen are bilateral pulmonary parenchymal opacities, with interval improvement along the right mid and lower zones since the ___ radiograph. Opacities across the left lung are unchanged. There is no pneumothorax. Small bilateral pleural effusions are stable. ,

Interval decrease of right pulmonary parenchymal opacities, reflecting improvement since ___. Unchanged small bilateral pleural effusions.

AP

143

50,880,103

10,337,896

null

Findings on the chest CT ___ showed probable multi focal pneumonia, predominantly in the right lung, and mild interstitial edema. Edema improved between ___ and ___, and then opacification in the right lung increased again accompanied by increasing moderate right pleural effusion. The progression of these associated findings this suggested that the interval change was primarily due to cardiac decompensation. Today edema has worsened in both lungs, and the moderate right pleural effusion is larger, although the opacification in the left lower lung is heterogeneous enough to suggest concurrent pneumonia or large scale aspiration. . Mild cardiomegaly and chronic mediastinal widening are chronic.

AP

144

53,275,640

10,337,896

The tracheostomy tube is unchanged in position and terminates approximately 4.8 cm above the carina. The right PICC line terminates in the distal SVC. There is no significant change in the lungs when compared to ___. There are several parenchymal calcifications which were characterized on the most recent CT scan. Again noted are diffuse infiltrative parenchymal opacities, right worse than left; this is largely due to pulmonary edema and the right-sided pleural effusion, but underlying pneumonia cannot be excluded. The mediastinum is wide, which was noted as far back as the outside hospital CXR from ___. No acute osseous abnormalities.

1. Moderate pulmonary edema, unchanged. 2. Interval improvement in right-sided pleural effusion.

AP

145

53,323,373

10,337,896

null

In comparison with the study of ___, there is little change. Diffuse bilateral pulmonary opacification with areas of calcificationpersist with bilateral pleural effusions and no change in the monitoring and support devices.

AP

146

53,482,443

10,337,896

null

Endotracheal tube and right internal jugular central line are unchanged position. Nasogastric tube is seen coursing to the level of the distal esophagus but the tip is not identified. Multiple calcified lymph nodes, multiple bilateral calcified parenchymal opacities and pleural calcifications are unchanged consistent with prior granulomatous infection. Given the extensive parenchymal abnormality, this does limit the sensitivity of plain radiography. Bilateral apical pleural thickening, left greater than right, which is unchanged. There are stable bilateral layering effusions, left greater than right, with probable associated compressive atelectasis in the lower lobes. No overt pulmonary edema. Heart remains stably enlarged. Bilateral glenohumeral degenerative changes with deformity of the left humeral head.

AP

147

53,778,461

10,337,896

Multiple calcified pulmonary nodules and calcified lymph nodes within the neck. Severe degenerative changes of the glenohumeral joints. Bilateral pleural effusions with bibasilar atelectasis. Developing bibasilar consolidation is difficult to exclude. No pneumothorax.

Small bilateral pleural effusions with passive atelectasis. Developing bibasilar consolidations are difficult to exclude. Redemonstrated densities within the lung parenchyma and neck, possibly secondary to prior granulomatous disease.

AP

148

53,799,148

10,337,896

null

Interval placement of an endotracheal tube which has its tip approximately 4.5 cm above the carina. Nasogastric tube appears to be coursing below the diaphragm with the tip not identified. Right internal jugular central line is unchanged in position. Overall stable cardiac mediastinal contours. No interval change in the bilateral multiple calcified lymph nodes and parenchymal and pleural opacities. Unchanged layering bilateral effusions. Asymmetric biapical pleural thickening, left greater than right, all is unchanged dating back to ___. No pneumothorax.

AP

149

54,031,658

10,337,896

null

As compared to the previous radiograph, the parenchymal opacities ___ notably on the left, have moderately decreased in severity. The monitoring and support devices are unchanged. Unchanged moderate cardiomegaly. Unchanged known intra and extra thoracic lymph node calcifications.

AP

150

54,346,165

10,337,896

AP portable semi upright view of the chest. Multiple calcified lymph nodes again seen projecting over the chest and neck. The previously noted tracheostomy tube is no longer seen. Calcified pleural plaque along the right hemidiaphragm noted along with multiple bilateral calcified pulmonary nodules. A small right pleural effusion is likely present. No convincing signs of pneumonia. The cardiomediastinal silhouette appears grossly within normal limits. Severe degenerative disease at both shoulders is again noted.

No convincing evidence for pneumonia. Chronic changes as detailed above.

AP

151

54,785,280

10,337,896

An ET tube is present approximately 3.6 cm above the carina. The enteric tube is present the distal tip off the film. There is no pneumothorax. There are small bilateral effusions. Dense calcified opacities in both upper lung fields and hila are noted, consistent with prior history of tuberculosis. Atelectasis or consolidation of the lung bases are noted. Reticular changes are also noted, which may be acute or chronic.

null

AP

152

54,966,187

10,337,896

null

In comparison with the study of ___, there is little change. Monitoring and support devices remain in place. Diffuse bilateral pulmonary opacifications persist along with multiple dense calcifications.

AP

153

55,022,783

10,337,896

null

In comparison with the earlier study of this day, the monitoring and support devices are unchanged diffuse pulmonary opacification is processed and may be more prominent in the left base, suggesting some layering pleural effusion. .

AP

154

55,070,875

10,337,896

The NG tube not well visualized, but may pass into the abdomen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are in stable position from prior exam.

NG tube not well visualized, but may pass into the abdomen. If it is a better visualization is desired, repeat radiographs with abdominal technique can be performed.

AP

155

55,070,875

10,337,896

The NG tube not well visualized, but may pass into the abdomen. Diffuse bilateral pulmonary opacifications are again seen, unchanged from prior exam. ET tube and right IJ central line are in stable position from prior exam.

NG tube not well visualized, but may pass into the abdomen. If it is a better visualization is desired, repeat radiographs with abdominal technique can be performed.

AP

156

55,705,635

10,337,896

null

Minimal interval improvement of the pre-existing right pleural effusion, with subsequent increase in transparency of the right lung base. In the interval, the nasogastric tube has been removed. No other relevant changes.

AP

157

55,929,666

10,337,896

null

Endotracheal tube continues to have its tip approximately 4 cm above the carina. A right internal jugular central line is unchanged in position. Nasogastric tube appears to have pulled back into the mid esophagus. No interval change in appearance of the multiple calcified nodes, multiple calcified pleural plaques, and multiple calcified parenchymal opacities. Layering effusions with retrocardiac opacity likely reflecting compressive atelectasis. No pneumothorax. Asymmetric biapical pleural thickening unchanged. Bilateral humeral head degenerative changes with remodeling on the left.

AP

158

56,165,736

10,337,896

null

As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload. No other changes. The multiple known calcifications are constant in appearance. In the interval, the patient has received a tracheostomy tube. There is no pneumothorax.

AP

159

56,165,736

10,337,896

null

As compared to the previous radiograph, there is a minimal increase in diameter of the vascular structures, likely reflecting increased fluid overload. No other changes. The multiple known calcifications are constant in appearance. In the interval, the patient has received a tracheostomy tube. There is no pneumothorax.

AP

160

56,271,118

10,337,896

There is an ET tube which terminates 3.3 cm above the carina. The right IJ central venous catheter is in stable position with tip projecting over the low SVC. Again seen is an enteric tube with distal tip projecting below the lower limit of film, not visualized. Allowing for changes in differences in rotation, the cardiomediastinal silhouette is unchanged. The bilateral hila are not well visualized. There is again seen pulmonary vascular congestion and moderate pulmonary edema, possibly worsened in the left lung in comparison to prior radiograph. There is stable pleural thickening most notable in the left apex. There are at least small bilateral layering pleural effusions, stable in size. There is unchanged appearance of multiple bilateral calcified lymph nodes as well as pleural and parenchymal calcifications. There is no pneumothorax.

Moderate pulmonary edema, possibly worse in the left lung most prominently. Otherwise stable chest x-ray.

AP

161

56,329,890

10,337,896

ET tube is seen in stable position 3.7 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however side port is most likely above the GE junction, in comparison to prior radiograph. The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well seen. There is unchanged appearance of the bilateral lung parenchyma, with pulmonary vascular congestion and moderate pulmonary edema. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications. There is no pneumothorax.

1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.

AP

162

56,329,890

10,337,896

ET tube is seen in stable position 3.7 cm above the carina. Right IJ central venous catheter is in stable position projecting over the mid to lower SVC. Enteric tube is again seen coursing inferiorly with distal tip projecting approximately over the stomach, however side port is most likely above the GE junction, in comparison to prior radiograph. The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well seen. There is unchanged appearance of the bilateral lung parenchyma, with pulmonary vascular congestion and moderate pulmonary edema. There are unchanged small bilateral layering pleural effusions. There are stable multiple bilateral calcified lymph nodes, pleural and parenchymal calcifications. There is no pneumothorax.

1. Enteric tube with side port projecting above the GE junction. ___ require advancement. Otherwise stable support structures. 2. Unchanged lung parenchyma and stable small bilateral layering pleural effusions.

AP

163

56,437,767

10,337,896

There has been interval placement of a right internal jugular line with tip terminating in the lower SVC. There is no pneumothorax. There is no improvement in the lung fields since the recent prior study.

null

AP