CT chest template RA.. - Radiology Associates of the Fox Valley, SC

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File name: “CT chest with contrast”
CONTRAST ENHANCED CHEST CT
INDICATION:
[+Payable: Tumors: malignant neoplasm (lung, respiratory system), neoplasm (breast),
lymphoma; Diagnoses: emphysema, lung disease, Findings: pleural effusion, enlarged lymph
nodes; Symptoms: respiratory abnormality, shortness of breath, hemoptysis, chest pain
(unspecified), tightness in chest; Signs: swelling/mass/lump of chest; abnormal findings (lung
field); Injury (trauma): chest injury, trunk injury.+]
[+Nonpayable: chronic airway obstruction, abnormal weight loss, abdominal pain
(unspecified).+]
COMPARISON STUDIES: []
TECHNICAL INFORMATION: Volumetric data in an axial plane from above the thoracic inlet
to below the diaphragm was obtained following IV injection of [] mL of Isovue 370 mg/mL.
[+Optional as indicated: "Images were reviewed at a separate workstation, and axial and oblique
coronal MIP images were obtained and saved to PACS."+]
INTERPRETATION:
Pulmonary structures:
Lungs: []
Tracheobronchial tree: []
Pleura and pleural space: []
Cardiovascular structures:
Heart: []
Thoracic aorta and branches: []
Pulmonary arteries: []
Other structures:
Mediastinal and hilar lymph nodes: []
Musculoskeletal structures: []
Visualized neck: []
Visualized abdomen and esophagus: []
IMPRESSION:
[]
Dictated at []
ALTERNATIVE FOR CHEST CT
File name: “CT chest with contrast”
CONTRAST ENHANCED CHEST CT
INDICATION:
[+Payable: Tumors: malignant neoplasm (lung, respiratory system), neoplasm (breast),
lymphoma; Diagnoses: emphysema, lung disease, Findings: pleural effusion, enlarged lymph
nodes; Symptoms: respiratory abnormality, shortness of breath, hemoptysis, chest pain
(unspecified), tightness in chest; Signs: swelling/mass/lump of chest; abnormal findings (lung
field); Injury (trauma): chest injury, trunk injury.+]
[+Nonpayable: chronic airway obstruction, abnormal weight loss, abdominal pain
(unspecified).+]
COMPARISON STUDIES: []
TECHNICAL INFORMATION: Volumetric data in an axial plane from above the thoracic inlet
to below the diaphragm was obtained following IV injection of [] mL of Isovue 370 mg/mL.
[+Optional as indicated: "Images were reviewed at a separate workstation, and axial and oblique
coronal MIP images were obtained and saved to PACS."+]
INTERPRETATION:
Visualized neck: []
Musculoskeletal structures: []
Tracheobronchial tree: []
Lungs: []
Pleura and pleural space: []
Heart: []
Thoracic aorta and branches: []
Pulmonary arteries: []
Mediastinal and hilar lymph nodes: []
Visualized abdomen and esophagus: []
IMPRESSION:
[]
Dictated at []
Report from radreport.org
Exam Type: CT of the CHEST
Date and Time: <<Order Observation End Time>>
Clinical information: <<Clinical Information>>
Comparison: [ report / film / date ]
IMPRESSION: [
]
[<RECOMMENDATIONS:>] [
]
Procedure:
[<Oral contrast was administered.>]
[<100>] ml of [<IV Contrast Name>] was injected intravenously.
Chest :[<with intravenous contrast>][<without intravenous contrast>][<without
and with intravenous contrast>]
FINDINGS:
LUNG AND LARGE AIRWAYS: [<within normal limits.>]
PLEURA: [<within normal limits.>]
VESSELS: [<within normal limits.>][<Atherosclerotic changes in the aorta>]
[<and coronary arteries>][<.>]
HEART: [<normal size.>] [<No pericardial effusion.>]
MEDIASTINUM AND HILA: [<within normal limits.>]
CHEST WALL AND LOWER NECK: [<within normal limits.>]
UPPER ABDOMEN:[<within normal limits.>]
BONES: [<within normal limits.>]
[Other]
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