Case Study 3 Diagnostic 1
Dr Donna Harrison dictating
Diagnostic Imaging Report
Patient : Putul Barua
ID 135799
Room No. CCU4
X-ray 10-0460
Referring Physician: Simon Williams, MD from pulmonology.
Reason for exam is hemoptysis
Date of exam is 01/10
Procedure: Ct scan of chest without contrast
Findings: Ct scan of the chest was performed in 7 mm axial sections with no intrrveous contrast enhancement. Comparison is made to previous ct scans made during his admission last year. There is interval resolution of the previously noted cavitary lesions in both upper lobes. However, there is evidence of chronic residual infultrates or scarring in both upper lobes as well as in the mid- and lower-lung fields posteriorly. Heart again appears enlarged. There is evidence of mild bilateral pleural thickening. No interval pulmonary parynchimal or pleural based mass lesions. No mediastynal or hylar masses. No lymphadenopethy, no pleural effusions, and no significant lesions of the boney thorax.
Impression: Significant interval improvement with evidence of interval resolution of the previously described bilateral upper lobe cavitary lesions in the lungs since his previous CT scans.There is residual chronic infultrates or scarring in both upper lobes. There is also evidence of residual scarring or infiltrates in the mid and lower lung posteriorly. The heart is enlarged. No other significant findings.
End of report by Dr. Harrison
Dr. Donna Harrison dictating
Patient Putul Barua
ID 135799
Room CCU4
X-ray no. 10-0478
Referring phys. Simon williams md pulmonology
Reason for exam: intubated
Date of exam 01/12
Procedure; chest x-ray portable adult
Portable chest findings: when compated to the chest x-ray done previously, there is mild interval improvement in the pulmonary vascular congestion. There is no change in the heart size. ET tube, pulmonary artery catheter, and EKG leads remain in place.
Impression: mild interval improvement in the patient’s bilateral lung
Diagnostic Imaging Report
Patient : Putul Barua
ID 135799
Room No. CCU4
X-ray 10-0460
Referring Physician: Simon Williams, MD from pulmonology.
Reason for exam is hemoptysis
Date of exam is 01/10
Procedure: Ct scan of chest without contrast
Findings: Ct scan of the chest was performed in 7 mm axial sections with no intrrveous contrast enhancement. Comparison is made to previous ct scans made during his admission last year. There is interval resolution of the previously noted cavitary lesions in both upper lobes. However, there is evidence of chronic residual infultrates or scarring in both upper lobes as well as in the mid- and lower-lung fields posteriorly. Heart again appears enlarged. There is evidence of mild bilateral pleural thickening. No interval pulmonary parynchimal or pleural based mass lesions. No mediastynal or hylar masses. No lymphadenopethy, no pleural effusions, and no significant lesions of the boney thorax.
Impression: Significant interval improvement with evidence of interval resolution of the previously described bilateral upper lobe cavitary lesions in the lungs since his previous CT scans.There is residual chronic infultrates or scarring in both upper lobes. There is also evidence of residual scarring or infiltrates in the mid and lower lung posteriorly. The heart is enlarged. No other significant findings.
End of report by Dr. Harrison
Dr. Donna Harrison dictating
Patient Putul Barua
ID 135799
Room CCU4
X-ray no. 10-0478
Referring phys. Simon williams md pulmonology
Reason for exam: intubated
Date of exam 01/12
Procedure; chest x-ray portable adult
Portable chest findings: when compated to the chest x-ray done previously, there is mild interval improvement in the pulmonary vascular congestion. There is no change in the heart size. ET tube, pulmonary artery catheter, and EKG leads remain in place.
Impression: mild interval improvement in the patient’s bilateral lung