data.csv

,filename,findings
0,1_IM-0001-4001.dcm.png,the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of a pleural effusion . there is no evidence of pneumothorax . 
1,2_IM-0652-1001.dcm.png,borderline cardiomegaly . midline sternotomy xxxx . enlarged pulmonary arteries . clear lungs . inferior xxxx . 
2,3_IM-1384-1001.dcm.png,unknown
3,4_IM-2050-1001.dcm.png,"there are diffuse bilateral interstitial and alveolar opacities consistent with chronic obstructive lung disease and bullous emphysema . there are irregular opacities in the left lung apex , that could represent a cavitary lesion in the left lung apex . there are streaky opacities in the right upper lobe , scarring . the cardiomediastinal silhouette is normal in size and contour . there is no pneumothorax or large pleural effusion . "
4,5_IM-2117-1003002.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . cholecystectomy clips are present . small t-spine osteophytes . there is biapical pleural thickening , unchanged from prior . mildly hyperexpanded lungs . "
5,6_IM-2192-1001.dcm.png,heart size and mediastinal contour are within normal limits . there is no focal airspace consolidation or suspicious pulmonary opacity . no pneumothorax or large pleural effusion . mild degenerative change of the thoracic spine . 
6,7_IM-2263-1001.dcm.png,the cardiac contours are normal . basilar atelectasis . the lungs are clear . thoracic spondylosis . lower cervical arthritis . 
7,8_IM-2333-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is an interim cervical spinal fusion partly evaluated . "
8,9_IM-2407-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiac silhouette is not enlarged . there has been apparent interval increase in low density convexity at the left cardiophrenic xxxx . calcified granuloma is again seen in the right upper lobe . there is no consolidation , pleural effusion or pneumothorax . "
9,10_IM-0002-2001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . stable calcified granuloma within the right upper lung . no acute bone abnormality . . "
10,11_IM-0067-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
11,12_IM-0133-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
12,13_IM-0198-1001.dcm.png,"the cardiac silhouette is borderline enlarged . otherwise , there is no focal opacity . mediastinal contours are within normal limits . there is no large pleural effusion . no pneumothorax . "
13,14_IM-0256-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . mild hyperinflation appears similar to prior . no focal alveolar consolidation , no definite pleural effusion seen . scattered chronic appearing irregular interstitial markings , no typical findings of pulmonary edema . "
14,15_IM-0324-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . evidence of prior granulomatous disease . no acute osseous findings . 
15,16_IM-0389-1001.dcm.png,unknown
16,17_IM-0460-2001.dcm.png,no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures intact . 
17,18_IM-0520-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
18,19_IM-0583-1001.dcm.png,"heart size is normal . there is tortuosity of the thoracic aorta , stable compared with prior . no focal airspace disease or effusion . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . "
19,20_IM-0653-1001.dcm.png,the cardiac and mediastinal silhouettes are unremarkable . the lungs are well expanded and clear . there are no focal air space opacities . there is no pneumothorax or effusion . there are mild degenerative changes of the thoracic spine . 
20,21_IM-0729-1001-0001.dcm.png,unknown
21,22_IM-0810-1001.dcm.png,"the lungs are clear , and without focal air space opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax large pleural effusion . "
22,23_IM-0879-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
23,24_IM-0949-1001.dcm.png,cardiomediastinal silhouette is within normal limits of size and appearance . the pulmonary vascularity is unremarkable . lungs are expanded and clear of airspace disease . negative for pneumothorax or pleural effusion . limited bone evaluation reveals no acute abnormality . there is incompletely evaluated lumbar levoscoliosis . 
24,25_IM-1024-2001.dcm.png,the heart is within normal limits in size . surgical suture material projects over the right lung apex . the lungs are hyperlucent and hyperinflated compatible with emphysema . there is left lower lobe airspace disease identified . there is moderate left pleural effusion and small right pleural effusion . no visualized pneumothorax . 
25,26_IM-1090-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
26,27_IM-1168-2002.dcm.png,lungs are overall hyperexpanded with flattening of the diaphragms . no focal consolidation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the thoracic spine . 
27,28_IM-1231-1001.dcm.png,bilateral patchy pulmonary opacities noted . interval improvement in left base consolidative opacity . pulmonary vascular congestion again noted . stable enlarged cardiomediastinal silhouette . stable left xxxx . no evidence of pneumothorax . no large pleural effusions . 
28,29_IM-1302-1001.dcm.png,unknown
29,30_IM-1385-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . negative for pneumoperitoneum . bony thorax and soft tissue grossly unremarkable"
30,31_IM-1450-1001.dcm.png,unknown
31,32_IM-1511-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild blunting of right costophrenic xxxx . the lungs are otherwise grossly clear . 
32,33_IM-1576-13013.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . left axillary surgical clips . bony structures are intact . 
33,34_IM-1644-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
34,35_IM-1704-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is hyperexpansion of the lungs with flattening of the hemidiaphragms . there is no focal airspace opacity , pleural effusion , or pneumothorax . there multilevel degenerative changes of thoracic spine . "
35,36_IM-1776-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
36,37_IM-1847-0001-0002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . opacities in right mid lung . the lungs are otherwise grossly clear . 
37,38_IM-1911-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
38,39_IM-1978-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
39,40_IM-2050-1001.dcm.png,"mild hyperexpansion of the lungs . numerous bilateral rib deformities . no focal airspace disease . heart size is normal . no pneumothorax or effusion . large , flowing anterior endplate osteophytes of the thoracic spine . "
40,41_IM-2055-1001.dcm.png,"the cardiomediastinal silhouette is stable in appearance . no interval change in the diffuse increased bilateral pulmonary interstitial markings , greatest in the peripheral aspect of the left lung and left lung base . these opacities appear slightly increased as compared to prior examination . mild left-sided volume loss redemonstrated , unchanged . no pneumothorax or pleural effusion . the thoracic spine appears intact . "
41,42_IM-2063-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of focal infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
42,43_IM-2070-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
43,44_IM-2078-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . "
44,45_IM-2081-1001.dcm.png,stable cardiomegaly with vascular prominence without overt edema . no focal airspace disease . no large pleural effusion or pneumothorax . the are intact . 
45,46_IM-2090-1001.dcm.png,unknown
46,47_IM-2098-1001.dcm.png,unknown
47,48_IM-2103-1001.dcm.png,"the cardiac and mediastinal contours are within normal limits . the lungs are well-inflated and clear . there is an 8mm nodule in the left lower lobe , calcified granuloma . there is no pneumothorax or effusion . bony structures of the thorax are intact with minimal early degenerative change . "
48,49_IM-2110-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are degenerative changes of the thoracic spine . there is a calcified granuloma identified in the right suprahilar region . the aorta is mildly tortuous and ectatic . there is asymmetric right apical smooth pleural thickening . there are severe degenerative changes of the xxxx . "
49,50_IM-2118-2001.dcm.png,a lung volumes . lungs are clear without focal airspace disease . no pleural effusions or pneumothoraces . cardiomegaly . degenerative changes in the spine . 
50,51_IM-2125-1001.dcm.png,heart size is normal and cardiomediastinal silhouette is normal . there are scattered calcified granulomas throughout both lung xxxx . lungs are clear bilaterally otherwise . no bony or soft tissue abnormalities . 
51,52_IM-2131-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
52,53_IM-2138-1001.dcm.png,there extremely low lung volumes . there is right basilar opacity . there is no pneumothorax . there is no large pleural effusion . cardiac silhouette and mediastinal contours are within normal limits . 
53,54_IM-2145-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . minimal right basilar subsegmental atelectasis noted . cardio mediastinal silhouette is unremarkable . tortuosity of the thoracic aorta noted . scattered calcified granulomas are seen without evidence of active granulomatous/tuberculous process . visualized osseous structures of the thorax are without acute abnormality . "
54,55_IM-2154-1001.dcm.png,"lung lines remain low . however , no focal infiltrates are identified . heart and pulmonary are normal . "
55,56_IM-2160-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
56,57_IM-2170-1001-0002.dcm.png,"the tracheostomy tube tip is 5 cm above the carina . there are prominent diffuse bilateral interstitial opacities , stable from prior radiographs . there is no focal airspace consolidation . no pleural effusion . no pneumothorax . heart size is within normal limits . there are mild degenerative changes of the spine . "
57,58_IM-2177-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . mild scoliosis and degenerative changes of the thoracic spine noted . 
58,59_IM-2184-1001.dcm.png,"the cardiac silhouette , mediastinum , and pulmonary vasculature are unremarkable . there is stable elevation of the left hemidiaphragm . lungs are clear . no pleural fluid or pneumothorax is appreciated . cholecystectomy clips are noted in the right upper quadrant . "
59,60_IM-2192-1001.dcm.png,"stable appearance of hiatal hernia . clear right lung xxxx . in the left superior lower lobe there is a 1 . 9 x 1 . 8 cm round area of density which has increased in size compared to prior chest radiograph and recommend a chest , abdomen and pelvis with contrast as this area is suspicious for potential malignancy . normal cardiac contour . no pneumothorax or pleural effusion . "
60,61_IM-2197-1001.dcm.png,unknown
61,62_IM-2202-12012.dcm.png,status post sternotomy and cabg . heart size is normal . coronary vascular stent . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are stable . calcified mediastinal lymph xxxx . normal pulmonary vascularity . degenerative changes of the spine . 
62,62_IM-2202-4004.dcm.png,status post sternotomy and cabg . heart size is normal . coronary vascular stent . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are stable . calcified mediastinal lymph xxxx . normal pulmonary vascularity . degenerative changes of the spine . 
63,63_IM-2210-0001-0001.dcm.png,"stable flattening of the posterior diaphragm and scattered chronic appearing irregular interstitial markings with no focal alveolar consolidation . stable cardiomediastinal silhouette with normal heart size and aortic ectasia/tortuosity , stable mediastinal contours . no definite pleural effusion seen , no typical findings of pulmonary edema . following spine ossifications and marginal osteophytes again noted . "
64,64_IM-2218-4004.dcm.png,"2 images . heart size upper limits of normal . mediastinal contours are maintained . the patient is mildly rotated . there is a small to moderate sized right apical pneumothorax which measures approximately 2 . 0 cm . no focal airspace consolidation is seen . left chest is clear . no definite displaced bony injury is seen . results called xxxx . p . m . xxxx , xxxx . "
65,65_IM-2228-4004.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . deformity of the right clavicle related to remote is again seen . visualized upper abdomen grossly unremarkable . "
66,66_IM-2236-1001.dcm.png,"chest . both lungs are clear and expanded with no pleural air collections or parenchymal consolidations . heart and mediastinum remain normal . lumbosacral spine . xxxx , disc spaces , and alignment are normal . sacrum and sacroiliac joints are normal . "
67,67_IM-2243-8001.dcm.png,there are low volumes with bronchovascular crowding . no focal infiltrate or effusion . heart and mediastinal contours within normal limits . no displaced fracture identified . 
68,68_IM-2251-1001.dcm.png,unknown
69,69_IM-2258-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
70,70_IM-2264-3001.dcm.png,sequelae of old granulomatous disease . lungs are clear without focal airspace disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
71,71_IM-2273-1001.dcm.png,"the heart is upper limits of normal in size . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
72,72_IM-2280-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable . "
73,73_IM-2289-1001.dcm.png,unknown
74,75_IM-2303-1001.dcm.png,the heart size is stable . the aorta is ectatic and atherosclerotic but stable . sternotomy are again noted . the scarring in the left lower lobe is again noted and unchanged from prior exam . there are mild bilateral prominent lung interstitial opacities consistent with emphysematous disease . the calcified granulomas are stable . 
75,76_IM-2309-1001.dcm.png,apparent scarring within the lingula . lungs are otherwise clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
76,77_IM-2315-1001-0002.dcm.png,unknown
77,78_IM-2322-1001.dcm.png,unknown
78,78_IM-2322-3001.dcm.png,unknown
79,79_IM-2329-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
80,80_IM-2333-1001.dcm.png,"heart size and mediastinal contour within normal limits . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
81,80_IM-2333-3001.dcm.png,"heart size and mediastinal contour within normal limits . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
82,82_IM-2350-3001.dcm.png,"no airspace disease , effusion or noncalcified nodule . normal heart size and mediastinum . left axillary surgical clips unchanged visualized of the chest are within normal limits . "
83,83_IM-2358-1001.dcm.png,unknown
84,84_IM-2363-1001.dcm.png,"there are low lung volumes with bronchovascular crowding as a result . no pleural effusion , pneumothorax or focal airspace disease . cardiomediastinal silhouette is within normal limits . no free subdiaphragmatic air . "
85,85_IM-2372-1001.dcm.png,there are scattered calcified granulomas . no focal infiltrate . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . there are degenerative changes of the spine . 
86,86_IM-2380-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
87,86_IM-2380-3001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
88,87_IM-2390-1001.dcm.png,"no focal airspace disease , pleural effusion or pneumothorax . cardiomediastinal silhouette is within normal limits . no free subdiaphragmatic air . "
89,89_IM-2402-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
90,90_IM-2407-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . there are degenerative changes of the spine . 
91,91_IM-2415-2001.dcm.png,minimal right-to-left cardiomediastinal shift . the cardiomediastinal silhouette is otherwise normal size and configuration . pulmonary vasculature within normal limits . there is a moderate sized right pneumothorax . this measures 3 . 2 cm at the level the right apex . 
92,92_IM-2422-4004.dcm.png,unknown
93,93_IM-2428-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . negative for pneumoperitoneum . mild degenerative changes of the thoracic spine . "
94,94_IM-2436-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are similar to comparison exam and within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
95,95_IM-2445-1001.dcm.png,there is a single calcified granuloma in the right lung base . the lungs are otherwise grossly clear bilaterally . there is no pneumothorax or pleural effusion . cardiac and mediastinal silhouettes are normal . there are cholecystectomy clips in the right upper quadrant of the abdomen . small t-spine osteophytes are noted . 
96,96_IM-2450-2002.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . the mediastinal contours are normal . 
97,97_IM-2460-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
98,98_IM-2467-4004.dcm.png,frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . reduced lung volumes with basilar atelectasis . no focal airspace consolidation or pleural effusion . 
99,99_IM-2476-1001.dcm.png,normal heart and mediastinum . clear lungs . trachea is midline . no pneumothorax . no pleural effusion . radiopaque foreign body overlying left chest . 
100,100_IM-0002-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
101,101_IM-0011-4004.dcm.png,the heart is again mildly enlarged . mediastinal contours are stable . patient is somewhat rotated . the lungs are hypoinflated with elevated left hemidiaphragm . opacities compatible with atelectasis . no large effusion is seen . there is no focal consolidation . pulmonary vascularity is mildly accentuated . there are bilateral degenerative changes of the with probable chronic dislocation of the left humerus . correlate clinically . 
102,102_IM-0016-1001.dcm.png,"normal heart size . clear , hyperaerated lungs . no pneumothorax . no pleural effusion . substernal density may be related to a pectus deformity . "
103,103_IM-0023-1001.dcm.png,"the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac contour is within normal limits . compared to prior exam , there is prominence of the mediastinal contour near the right hilum . this may represent the ascending aorta or mediastinal lymphadenopathy . ct chest with contrast may be helpful for further evaluation . there are mild degenerative changes of the thoracic spine . "
104,105_IM-0037-1001.dcm.png,heart size within normal limits . stable position of left subclavian central venous catheter . no focal airspace disease . no pneumothorax . mild blunting of the costophrenic bilaterally . 
105,106_IM-0042-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
106,107_IM-0049-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
107,108_IM-0056-1001.dcm.png,the heart is normal in size . the mediastinum is within normal limits the lungs are hypoinflated . there is mild increase in perihilar markings related to patient's history bronchitis . no acute infiltrate or pleural effusion are seen . 
108,110_IM-0067-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
109,111_IM-0076-1001.dcm.png,unknown
110,112_IM-0080-1001.dcm.png,previous lower spine cervical fusion . lungs are overall hyperexpanded with flattening of the diaphragms consistent with obstructive lung disease . lungs are clear without focal consolidation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
111,113_IM-0086-1001.dcm.png,"the heart and mediastinum are unremarkable . there are two subcentimeter hyperdense nodular opacities are noted within the right lung . these may represent on end or alternatively , calcified granulomas . the lungs are clear without infiltrate . there is no effusion or pneumothorax . "
112,113_IM-0086-3001.dcm.png,"the heart and mediastinum are unremarkable . there are two subcentimeter hyperdense nodular opacities are noted within the right lung . these may represent on end or alternatively , calcified granulomas . the lungs are clear without infiltrate . there is no effusion or pneumothorax . "
113,114_IM-0096-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits . no pneumothorax or pleural effusions . the lungs are clear . no focal consolidations . the osseous structures are intact . 
114,115_IM-0102-1001.dcm.png,the lungs are clear . there is hyperinflation of the lungs . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
115,116_IM-0107-1001.dcm.png,"stable postsurgical changes . heart xxxx , mediastinum and lung are unremarkable . stable calcified small granuloma in left base . "
116,117_IM-0114-2002.dcm.png,unknown
117,118_IM-0123-1001.dcm.png,the heart is normal in size and contour . there is focal airspace disease in the right middle lobe . there is no pneumothorax or effusion . 
118,119_IM-0128-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
119,120_IM-0133-1001.dcm.png,"low lung volumes bilaterally with central bronchovascular crowding without focal consolidation , pleural effusion , or pneumothoraces . . cardiomediastinal silhouette is within normal limits . degenerative changes of the thoracic spine . . "
120,121_IM-0142-1001.dcm.png,heart size and vascularity normal . lungs are clear . no effusions . no pneumothorax . visualized osseous structures unremarkable . 
121,122_IM-0147-0001-0001.dcm.png,unknown
122,123_IM-0153-4004.dcm.png,mild cardiomegaly . tortuous aorta . no focal infiltrate . no pneumothorax or large pleural effusion . soft tissue density identified in the medial right apex which is asymmetric compared to left . 
123,124_IM-0161-4004.dcm.png,unknown
124,125_IM-0169-1001.dcm.png,the heart is normal in size . the mediastinum is stable . sternotomy changes are again noted . the lungs are clear of focal infiltrates . there is no pleural effusion . 
125,126_IM-0176-2002.dcm.png,vague increased opacity which appears to be within the left lower lobe . question of this could be developing or resolving pneumonia . lungs are otherwise clear . no pleural effusions or pneumothoraces . heart and mediastinum are stable normal size heart . atherosclerotic vascular disease . degenerative changes in the thoracic spine . 
126,127_IM-0181-1001.dcm.png,"heart size and mediastinal contour within normal limits . calcified granuloma in the left lung base . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
127,128_IM-0186-82592001.dcm.png,sequelae of old granulomatous disease . lungs are overall hyperexpanded with flattening of the diaphragms . no focal consolidation . prominent interstitial markings are again noted which are predominantly lower lobe and peripheral suggesting pulmonary fibrosis . this appearance is overall not significantly xxxx . no pleural effusions or pneumothoraces . heart and mediastinum are stable with atherosclerotic vascular disease . degenerative changes in the thoracic spine . 
128,129_IM-0189-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
129,131_IM-0202-1001.dcm.png,there is a calcified granuloma in the right midlung zone . lungs are otherwise clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . surgical clips are present in the right upper quadrant . 
130,132_IM-0206-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . tortuosity of the thoracic aorta . visualized osseous structures of the thorax are without acute abnormality . "
131,133_IM-0212-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
132,134_IM-0219-1001.dcm.png,calcified granulomata are present in the right middle lobe and right upper lobe . these are unchanged since the previous examination . both lungs are free of active infiltrates . heart size normal . 
133,135_IM-0227-1001.dcm.png,"the lungs are grossly clear without focal pneumonic consolidation , large effusion or pneumothorax . heart size is within normal limits . "
134,136_IM-0233-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
135,138_IM-0244-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
136,139_IM-0248-1001.dcm.png,"the cardiac silhouette is mildly enlarged . a lobulated opacity is identified superior to the heart , in the anterior mediastinum on the lateral view , possibly consistent with a tortuous/ectatic thoracic aorta versus an anterior mediastinal mass . the thoracic aorta is tortuous and calcified . no focal areas of pulmonary consolidation . the lungs are hyperexpanded with flattening of the bilateral hemidiaphragms . no pneumothorax or pleural effusion . severe degenerative changes of the thoracic spine . "
137,141_IM-0260-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
138,142_IM-0267-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are stable and within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
139,143_IM-0276-1001.dcm.png,the lungs are clear . no pleural effusion is seen . the heart is normal . calcified right hilar and infracarinal lymph are seen . the skeletal structures are normal . 
140,144_IM-0283-1001.dcm.png,overall low lung volumes with mild patchy bibasilar airspace disease . this most represents atelectasis given the low lung volumes . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
141,145_IM-0290-1001.dcm.png,right costophrenic is blunted . in the left lower lobe a patchy infiltrate is present . the pulmonary are normal . 
142,146_IM-0298-1001-0001.dcm.png,unknown
143,147_IM-0303-1001.dcm.png,the lungs are clear . heart and pulmonary appear normal . the pleural spaces are clear and mediastinal contours are normal . nodular density overlying the anterior left 4th rib represents a healing rib fracture . 
144,149_IM-0315-1001.dcm.png,unknown
145,150_IM-0325-0001-0001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . "
146,151_IM-0331-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
147,152_IM-0335-2001.dcm.png,"stable cardiomediastinal silhouette with mild cardiomegaly and aortic ectasia and tortuosity . no alveolar consolidation , no findings of pleural effusion . chronic appearing bilateral rib contour deformities compatible with old fractures . no pneumothorax . "
148,153_IM-0343-1001.dcm.png,"there is a right ij central venous catheter with tip overlying the inferior svc . cardiac silhouette is normal size . normal mediastinal contour and pulmonary vasculature . there is a small right pleural effusion . otherwise , lungs are without focal airspace disease . "
149,154_IM-0350-1001.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . "
150,155_IM-0358-1001.dcm.png,unknown
151,157_IM-0372-1001.dcm.png,"in the interval , bibasilar interstitial infiltrates and pulmonary venous engorgement have resolved . heart size is now normal . no infiltrates . "
152,158_IM-0377-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
153,159_IM-0382-1001.dcm.png,"chest . the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . left and right xxxx . osteophytes are present at the acromioclavicular joints bilaterally and also on the humeral necks . the right glenohumeral joint is normal , but the left is narrowed . no fractures or bone destruction . "
154,160_IM-0390-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there is patchy infiltrate within normal right lower lobe . mild opacities in the retrocardiac region . no large effusions or pneumothorax . 
155,161_IM-0394-1001.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . no pleural effusion or pneumothorax is seen . scattered of left base atelectasis are noted . left xxxx-a-xxxx is in with the tip projecting over the caval atrial junction . 
156,162_IM-0401-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
157,163_IM-0410-12012.dcm.png,there are no airspace opacities to suggest pneumonia . there is a vague nodular like opacity in the right midlung measuring 1 . 2 cm projecting through the posterior 7th and 8th ribs . this may be artifact . chest fluoroscopy would confirm this . heart and pulmonary appear normal . there are calcified subcarinal and right hilar lymph xxxx . the pleural spaces are clear . 
158,163_IM-0410-2002.dcm.png,there are no airspace opacities to suggest pneumonia . there is a vague nodular like opacity in the right midlung measuring 1 . 2 cm projecting through the posterior 7th and 8th ribs . this may be artifact . chest fluoroscopy would confirm this . heart and pulmonary appear normal . there are calcified subcarinal and right hilar lymph xxxx . the pleural spaces are clear . 
159,164_IM-0419-1001.dcm.png,the cardiopulmonary silhouette is normal . the heart size is normal . the lungs are clear with no pulmonary effusions or pneumothorax . 
160,165_IM-0427-1001.dcm.png,there is some minimal biapical scarring . a calcified granuloma is present in the right middle lobe . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
161,166_IM-0435-2002.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified lymph and granuloma are noted . mild degenerative changes are present in the spine . 
162,167_IM-0441-1001.dcm.png,both lungs are clear and expanded . an old calcified granuloma is present in the left upper lobe . heart and mediastinum normal . 
163,168_IM-0448-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax demonstrates stable mild multilevel degenerative disc disease of the thoracolumbar spine as well as chronic left-sided rib fractures without acute abnormality . "
164,169_IM-0452-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
165,170_IM-0461-0001-0003.dcm.png,unknown
166,171_IM-0468-1001.dcm.png,unknown
167,172_IM-0474-1001.dcm.png,elevated right hemidiaphragm . clear lungs . no pleural effusions or pneumothoraces . heart size is upper limits of normal with tortuosity and ectasia of the aorta . generative changes within the spine . in the upper lumbar spine there is an age-indeterminate wedge of a vertebral body . 
168,173_IM-0481-1001.dcm.png,"low lung volumes . cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . calcified bilateral hilar lymph xxxx , greater on the left . no acute osseous findings . "
169,174_IM-0488-1001.dcm.png,"there is a left-sided picc with tip at the caval atrial junction . the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . stable short segment catheter tubing overlying the left xxxx , to reside within anterior chest soft tissues on recent chest ct . stable remote posttraumatic changes of multiple right ribs . "
170,175_IM-0492-1001.dcm.png,"mild cardiomegaly unchanged . stable superior mediastinal contour with tortuous aorta . normal pulmonary vascularity . unchanged elevated right hemidiaphragm with minimal right base subsegmental atelectasis . minimal left basal airspace opacity . unchanged blunting of the right lateral costophrenic xxxx , scarring versus effusion . no pneumothorax . no acute osseous findings . "
171,176_IM-0496-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
172,177_IM-0503-1001.dcm.png,"the heart size is enlarged . the mediastinal contour is within normal limits . calcification is seen within the aortic xxxx . interstitial opacities . there are no nodules or masses . stable appearing right perihilar calcified granulomas . no visible pneumothorax . bilateral costophrenic blunting , left worse than right . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . "
173,178_IM-0509-2001.dcm.png,"cardiomediastinal silhouette stable with atherosclerosis of the thoracic aorta . diffusely coarsened interstitial markings are noted consistent with chronic lung disease , with worsened patchy opacities and a left apex and right base . no pneumothorax or pleural effusion . no acute bony abnormality . "
174,179_IM-0514-1001.dcm.png,"no airspace disease , effusion or noncalcified nodule . normal heart size and mediastinum . visualized of the chest are within normal limits . "
175,181_IM-0524-1001.dcm.png,normal heart size mediastinal contours . eventration of the right hemidiaphragm . no focal airspace consolidation . no pleural effusion or pneumothorax . 
176,182_IM-0531-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . patchy airspace opacities in the left lower lobe , compatible with infiltrate . no large pleural effusion . no pneumothorax . no acute bony abnormality . "
177,183_IM-0537-1001.dcm.png,heart size within normal limits . there are low lung volumes with bronchovascular crowding . there is mild increased airspace opacity within the right lung base which may represent atelectasis or infiltrate . . no visualized pneumothorax or large pleural effusion . multilevel degenerative disease of the spine . 
178,184_IM-0544-1001.dcm.png,pa and lateral views were obtained . lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . a 5 mm stable right apical nodule . 
179,185_IM-0551-1001.dcm.png,the heart is normal in size . the mediastinum is stable . lungs are mildly hypoinflated . increased opacities on lateral projection reflect bronchovascular crowding . there is no acute infiltrate or pleural effusion . 
180,186_IM-0558-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . no evidence of abnormal radiodense foreign bodies . "
181,187_IM-0563-1001.dcm.png,"normal heart size . stable tortuous aorta . no pneumothorax , pleural effusion or suspicious focal airspace opacity . prior granulomatous disease . "
182,188_IM-0569-1001.dcm.png,unknown
183,189_IM-0578-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a 1 cm focal opacity in the right lung apex incompletely evaluated by this exam . there is minimal left basilar opacity compatible with scarring or atelectasis . there are degenerative changes of the spine . "
184,190_IM-0583-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . there is no obvious lytic or destructive lesion . no displaced rib fracture is evident . 
185,191_IM-0591-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
186,192_IM-0598-1001.dcm.png,"low lung volumes . heart size and mediastinal contour within normal limits . no focal air space consolidation , pneumothorax , or pleural effusion . mild thoracic spine degenerative change . "
187,193_IM-0601-1001.dcm.png,this is an apical lordotic view the chest . heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
188,194_IM-0609-2001.dcm.png,heart size upper limits of normal . small amount of left basilar airspace disease . the right lung is clear . there are no cavitary lesions seen . no pneumothorax . no pleural effusions . 
189,195_IM-0618-1002.dcm.png,clear lungs bilaterally . no pneumothorax or pleural effusion . normal cardiac contours
190,196_IM-0626-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours , lungs , pleura , osseous structures and visualized upper abdomen are normal . "
191,197_IM-0631-1001.dcm.png,the cardiomediastinal silhouette is normal . lungs are hyperexpanded but clear without evidence of effusion or infiltrate . there is a small right lower lobe calcified granuloma that is unchanged from prior examinations . no acute bony abnormality . no pneumothorax or pneumomediastinum . 
192,200_IM-0653-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
193,201_IM-0660-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is minimal airspace opacity in the right middle lobe , atelectasis . the lungs are otherwise clear of focal airspace disease . there is no pneumothorax or pleural effusion . there is mild tortuosity of the thoracic aorta with atherosclerotic calcification of the aortic xxxx . there are moderate degenerative endplate changes in the thoracic spine . there are no acute bony findings . "
194,202_IM-0667-4004.dcm.png,ap and lateral view of the chest . 
195,203_IM-0675-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
196,204_IM-0683-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
197,205_IM-0689-2002.dcm.png,unknown
198,206_IM-0697-6001.dcm.png,chest comparison: there is a 2 . 6 cm diameter masslike density over the lingula partial obscuration left cardiac xxxx . there may be some ill-defined opacity in the right mid and lower lung zone . no pleural effusion is seen . the heart is borderline enlarged . the aorta is dilated and tortuous . arthritic changes of the spine are present . pelvis and left hip there is an impacted and rotated fracture through the neck of the femur on the left . no pelvic fracture is seen . arthritic changes are present in the lower lumbar spine . large amount of stool and obscures portions of the pelvis . femur the femoral images do not the area of the hip fracture . the remaining portions of the femur appear to be intact with no fracture or destructive process . extensive atherosclerotic vascular disease throughout the superficial femoral artery is present . left knee there is osteoporosis and mild arthritic changes . no fracture is seen . no dislocation is identified . severe atherosclerotic changes of the superficial femoral and popliteal artery are seen . 
199,207_IM-0703-1001.dcm.png,normal heart size and mediastinal contours . the lungs are clear . there is no pneumothorax or pleural effusion . no acute bony abnormalities . 
200,208_IM-0711-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
201,209_IM-0721-1001.dcm.png,unknown
202,210_IM-0730-1001.dcm.png,there are numerous surgical clips at the thoracic inlet . small areas of scarring are seen in the left base . the lungs are otherwise clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
203,210_IM-0730-2001.dcm.png,there are numerous surgical clips at the thoracic inlet . small areas of scarring are seen in the left base . the lungs are otherwise clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
204,211_IM-0740-1001.dcm.png,normal heart size . clear lungs . trachea is midline . no pneumothorax . no pleural effusion . 
205,212_IM-0746-1001-0001.dcm.png,chest: stable cardiomediastinal silhouette . pulmonary vascularity is within normal limits . hyperlucent apices . negative for focal airspace disease or consolidation . negative for pneumothorax or pleural effusion . healed remote left 9th rib fracture . right shoulder: negative for fracture or dislocation . 
206,212_IM-0746-1001-0002.dcm.png,chest: stable cardiomediastinal silhouette . pulmonary vascularity is within normal limits . hyperlucent apices . negative for focal airspace disease or consolidation . negative for pneumothorax or pleural effusion . healed remote left 9th rib fracture . right shoulder: negative for fracture or dislocation . 
207,215_IM-0769-1001.dcm.png,stable cardiomegaly . sternotomy are intact . no pneumothorax or pleural effusion . calcific density in the left mid to upper lung represents old granulomatous disease . no focal consolidation . stable moderate thoracic levoscoliosis and mild thoracolumbar dextroscoliosis . 
208,216_IM-0777-2001.dcm.png,the cardiac silhouette is enlarged and has a globular appearance . mild bibasilar dependent atelectasis . no pneumothorax or large pleural effusion . no acute bone abnormality . 
209,217_IM-0786-1001.dcm.png,unknown
210,218_IM-0792-4004.dcm.png,heart size is unchanged . aortic calcification is noted . no pneumothorax . no large pleural effusions . there are unchanged opacities throughout the lungs which represent scarring . lungs are hyperexpanded . 
211,219_IM-0799-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
212,220_IM-0811-1001.dcm.png,the heart is normal in size . the mediastinum is stable . left-sided chest is again visualized with tip at cavoatrial junction . there is no pneumothorax . numerous bilateral pulmonary nodules have increased in size and number compared to prior study . the dominant nodule/mass in the left midlung is also mildly increased . there is no pleural effusion . 
213,221_IM-0817-1001.dcm.png,"cardiac and mediastinal contours are within normal limits . atherosclerotic aorta . mild blunting left costophrenic recess , possibly mild atelectasis or scarring . no confluent lobar consolidation or large volume pleural effusion . thoracic spondylosis . "
214,222_IM-0823-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
215,223_IM-0831-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . bronchovascular crowding without typical findings of pulmonary edema . "
216,224_IM-0837-1001.dcm.png,clear lungs . normal heart . no pneumothorax . no pleural effusion . old right rib fractures . 
217,225_IM-0844-1001.dcm.png,cardiomediastinal silhouette is within normal limits . no focal consolidation . no pneumothorax or pleural effusion . no acute bony abnormalities . 
218,226_IM-0851-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
219,227_IM-0859-12012.dcm.png,"heart is enlarged . there is prominence of the central pulmonary vasculature . mild diffuse interstitial opacities bilaterally , predominantly in the bases , with no focal consolidation , pleural effusion , or pneumothoraces . and soft tissues are unremarkable . "
220,227_IM-0859-4004.dcm.png,"heart is enlarged . there is prominence of the central pulmonary vasculature . mild diffuse interstitial opacities bilaterally , predominantly in the bases , with no focal consolidation , pleural effusion , or pneumothoraces . and soft tissues are unremarkable . "
221,228_IM-0866-3001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . surgical is noted in the right upper quadrant . subcutaneous emphysema seen along the neck bilaterally , right lateral upper abdomen , and left chest . "
222,229_IM-0873-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . mediastinal calcification and dense right upper lung nodule suggest a previous granulomatous process . "
223,230_IM-0880-0001-0002.dcm.png,unknown
224,233_IM-0899-1001.dcm.png,"atrial septal occluder artifact . rotated frontal position , overall heart size within normal limits , no typical findings of pulmonary edema . densities in the left base , small focal opacity in the right base with focal posterior right hemidiaphragm elevation and obscured right costophrenic xxxx . biapical pleuroparenchymal irregularities most compatible with scarring , chronic appearing right 5th rib contour deformity . no pneumothorax seen . "
225,234_IM-0906-0001-0001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without focal consolidation or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . no layering pleural effusion or pneumothorax seen on decubitus exam . "
226,236_IM-0924-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
227,237_IM-0930-2001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . there are numerous calcified granuloma in the right perihilar region . there are multilevel degenerative changes in the thoracic spine . "
228,238_IM-0939-1001.dcm.png,"stable cardiomediastinal silhouette . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . "
229,239_IM-0944-1001.dcm.png,unknown
230,240_IM-0950-1001.dcm.png,"chest . there is no change in the strandy scarring in the right apex . no infiltrates or masses in the lungs . heart and mediastinum remain normal . lumbosacral spine . disc spaces are old narrow , and large osteophytes present on the vertebral bodies , worst at l2-l3 . elements from l4 through s1 are sclerotic . sacrum and sacroiliac joints are normal . calcific aortic disease is present . "
231,241_IM-0955-1001.dcm.png,the trachea is midline . cardiomediastinal silhouette is normal in size and contour . the lungs are clear without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . 
232,242_IM-0963-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
233,243_IM-0971-2001.dcm.png,unknown
234,244_IM-0978-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . "
235,245_IM-0985-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate left upper lobe airspace disease most pneumonia . there is no effusion or pneumothorax . 
236,246_IM-0992-1002001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
237,247_IM-1000-1001.dcm.png,the cardiomediastinal silhouette is normal in size and contour . lungs are clear without focal areas of consolidation . no pneumothorax or large pleural effusion . no acute bone abnormality . 
238,248_IM-1008-85149002.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . are intact . there is a small calcified granuloma in the right midlung . "
239,249_IM-1016-1001.dcm.png,"lobulated right middle lobe mass measuring 4 . 5 x 6 . 8 cm , increased in size compared to prior study , most compatible with neoplasm . otherwise , the lungs are clear without focal consolidation . no pneumothorax or pleural effusion . cardiomediastinal silhouette within normal limits . "
240,250_IM-1025-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are normal . there are minimal degenerative changes of the spine . 
241,251_IM-1032-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild hyperinflation is noted . there are granulomatous sequela . no acute infiltrate or significant pleural effusion are noted . the costophrenic are excluded . 
242,251_IM-1032-3001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild hyperinflation is noted . there are granulomatous sequela . no acute infiltrate or significant pleural effusion are noted . the costophrenic are excluded . 
243,252_IM-1038-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
244,253_IM-1045-1001.dcm.png,redemonstration of moderate left pneumothorax which is unchanged from comparison . left pleural catheter is again seen overlying the left upper lung at the level of the left 5th and 6th ribs . no focal consolidation . cardiomediastinal silhouette is normal . 
245,254_IM-1051-1001.dcm.png,lungs are clear . heart size normal . scattered thoracic spine spurring . 
246,255_IM-1058-1001.dcm.png,"lungs are clear . no focal consolidation , effusion , or pneumothorax . heart and mediastinal contours are normal . osseous structures intact . "
247,256_IM-1064-1001.dcm.png,postoperative changes are present in the left fifth rib . residual radiopaque sutures are also present in the left upper lobe . the lungs are clear with no infiltrates or masses . heart and mediastinum are normal . 
248,257_IM-1072-1001.dcm.png,midline sternotomy identified . heart size and cardiomediastinal silhouette are grossly normal . airspace opacity in posterior segment on the lateral view . osseous structures are grossly intact . 
249,258_IM-1078-1001.dcm.png,overall hyperexpanded lungs with flattening of the diaphragms consistent with obstructive lung disease . lungs are clear without focal consolidation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
250,259_IM-1083-1001.dcm.png,"the heart and cardiomediastinal silhouette or normal in size and contour . there is no focal air space opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
251,260_IM-1090-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . there is a stable the electronic device any left anterior chest wall . there are advanced degenerative changes in the bilaterally . there is a 38 mm lucency in the right humeral head with geographic 1a margins . 
252,261_IM-1100-1001.dcm.png,no focal areas of consolidation . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures appear intact . 
253,261_IM-1100-12012.dcm.png,no focal areas of consolidation . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures appear intact . 
254,262_IM-1109-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no discrete nodules or adenopathy are noted . degenerative changes are present in the spine . 
255,264_IM-1125-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . no significant interval change compared to prior study , no infiltrates noted . "
256,266_IM-1141-4004.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size is mildly enlarged , pulmonary vascularity within normal limits . atherosclerotic calcifications are present in the aortic xxxx . "
257,267_IM-1147-1001.dcm.png,endotracheal tube and ng tube have been removed . mild patchy bilateral airspace disease . there are small bilateral pleural effusions . no pneumothorax . heart and mediastinum are stable with normal size heart . degenerative changes in the spine . 
258,268_IM-1153-1001.dcm.png,there is a right upper lobe opacity . cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . osseous structures and soft tissues are normal . 
259,269_IM-1161-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
260,270_IM-1168-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
261,271_IM-1176-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
262,272_IM-1182-1001.dcm.png,the lungs are clear . no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . 
263,273_IM-1188-1001.dcm.png,"heart size mildly to moderately enlarged . mild right hemidiaphragm elevation with mild bronchovascular crowding , right greater than left , indistinct vascular margination . no definite focal alveolar consolidation , no pleural effusion demonstrated . "
264,274_IM-1194-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is tortuous and calcified . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . degenerative endplate changes of the thoracic spine with an age-indeterminate , mild wedge deformity of a midthoracic vertebral body . "
265,275_IM-1200-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
266,276_IM-1207-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
267,277_IM-1213-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . mild biapical scarring is identified . there is a nodular density in the right midlung which is stable from prior studies and noted to represent a granuloma on of xxxx . however , additional foci in the right upper lung are questioned . there is no acute infiltrate or pleural effusion . "
268,278_IM-1218-1001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . heart size normal . stable cardiomediastinal silhouette . nodular opacities consistent with chronic granulomatous disease . bony structures intact . "
269,279_IM-1224-1001-0002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
270,280_IM-1232-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
271,282_IM-1243-1001.dcm.png,"mediastinal contours are within normal limits . heart size is within normal limits . no focal consolidation , pneumothorax or pleural effusion . "
272,283_IM-1248-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
273,284_IM-1252-5005.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . no discrete projectile visualized . contrast within the bilateral renal collecting systems . contrast also probably within the left colon . "
274,285_IM-1258-4004.dcm.png,unknown
275,286_IM-1267-3001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . calcified left suprahilar xxxx . the heart and mediastinum are within normal limits . bony structures are intact . 
276,287_IM-1276-4004.dcm.png,heart size is normal . the lungs are grossly clear . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are stable . normal pulmonary vascularity . no overt edema . 
277,288_IM-1284-1001.dcm.png,"heart size appears within normal limits . pulmonary vasculature appears within normal limits . radiodensity overlying the middle cardiac silhouette , representing a hiatal hernia . no focal consolidation , pleural effusion or pneumothorax . no acute bony abnormality . "
278,289_IM-1292-0001-0001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours , right chest tip in the low svc . monitoring device artifacts . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
279,290_IM-1303-1001.dcm.png,the lungs are clear . there are multiple surgical seen near the apical regions and lower cervical region bilaterally . the heart and mediastinum are normal . there is a screw in the right shoulder . the soft tissues are normal . 
280,291_IM-1313-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
281,292_IM-1322-1001.dcm.png,the heart is normal in size and contour . there is a vague area of airspace disease identified within the right midlung on the pa view . this is not well-demonstrated on the lateral view . there is no pneumothorax or effusion . 
282,293_IM-1332-1001.dcm.png,"sternotomy mediastinal clips noted . heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . there is deformity of t6 , since x-xxxx thoracic spine xxxx , xxxx . mild deformity of t12 , stable . prior cholecystectomy . "
283,294_IM-1340-3001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are grossly clear . underlying emphysematous changes are noted . 
284,295_IM-1348-1001.dcm.png,"limited lateral projection . the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . healed distal left clavicular fracture noted . "
285,296_IM-1354-1001.dcm.png,unknown
286,297_IM-1361-4004.dcm.png,"cardiac silhouette is within normal limits in size . the lungs are hypoinflated with mild bronchovascular crowding . there is mild , opacity projected over the left lung base . this is partly due to overlying soft tissues , however , there is partial obscuration of the lateral left hemidiaphragm . the lungs are otherwise grossly clear . there is no pneumothorax or pleural effusion . there are no acute bony findings . there are degenerative endplate changes throughout the thoracic spine . "
287,298_IM-1369-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
288,299_IM-1377-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . small hiatal hernia . 
289,300_IM-1385-1001.dcm.png,heart size within normal limits . mild hyperinflation of the lungs . mild pectus excavatum deformity . stable left mid lung calcified granuloma . no focal airspace disease . no pneumothorax or effusions . 
290,301_IM-1389-1001.dcm.png,normal cardiomediastinal contours . clear lungs bilaterally . no pneumothorax or large effusion . 
291,302_IM-1394-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . mild spine curvature again noted . "
292,303_IM-1404-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . rectal balloon is noted . lungs are mildly hypoinflated . there is again eventration of the hemidiaphragms/ bochdalek hernia , posteriorly as seen on the lateral projection . bilateral pleural thickening is noted . there are streaky opacities in the lung bases unchanged , chronic atelectasis . "
293,304_IM-1413-12012.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . a total of 3 images were obtained . the cardiomediastinal contours are within normal limits allowing for low lung volumes and patient rotation . there is atelectasis . no consolidation , pleural effusion or pneumothorax . calcified right infrahilar lymph again seen . partially visualized lower cervical spine fusion xxxx . "
294,304_IM-1413-4004.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . a total of 3 images were obtained . the cardiomediastinal contours are within normal limits allowing for low lung volumes and patient rotation . there is atelectasis . no consolidation , pleural effusion or pneumothorax . calcified right infrahilar lymph again seen . partially visualized lower cervical spine fusion xxxx . "
295,306_IM-1426-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . 
296,307_IM-1432-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
297,308_IM-1439-1001.dcm.png,stable appearing right-sided the opacities . there is persistent elevation of the right hemidiaphragm . the cardiac silhouette and mediastinal contours are within normal limits . there is no pneumothorax . 
298,309_IM-1444-1001.dcm.png,normal and stable cardiomediastinal contours . no pneumothorax or pleural effusions . no focal lung consolidation . 
299,310_IM-1451-0001-0001.dcm.png,"chest . the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . thoracic spine . the examination consists of frontal , lateral and swimmers lateral radiographs of the thoracic spine . there is no evidence of fracture or malalignment . the vertebral body and disc spaces are maintained . sternum . the examination consists of 2 oblique and one lateral radiograph of the sternum . no displaced fracture demonstrated . "
300,312_IM-1466-1001.dcm.png,"normal cardiomediastinal silhouette . left-sided aortic xxxx . pulmonary vasculatures are within normal limits . central airways are xxxx . no focal consolidation , pleural effusion or pneumothorax . bony structure are grossly unremarkable . "
301,313_IM-1472-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiac silhouette is moderately enlarged with a cardiothoracic ratio of 16 . 2/24 . 7 . diffuse coarse interstitial opacity seen throughout the lungs with perihilar and lower lobe predominance . there is right greater than left bibasilar consolidation . there are small pleural effusions , right larger than left . no evidence of pneumothorax . dense atherosclerotic calcification seen involving the thoracic and upper abdominal aorta . "
302,314_IM-1477-1001.dcm.png,low lung volumes . normal heart size . the trachea is midline . lungs are clear . no pneumothorax . no pleural effusion . 
303,315_IM-1481-1001.dcm.png,unknown
304,316_IM-1487-1001.dcm.png,unknown
305,317_IM-1493-1001.dcm.png,normal heart size . normal mediastinal silhouette . no pneumothorax or pleural effusion . no suspicious focal air space opacity . 
306,318_IM-1500-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
307,319_IM-1505-1001.dcm.png,normal heart size . clear lungs . no pneumothorax . no pleural effusion . 
308,320_IM-1511-1001.dcm.png,unknown
309,321_IM-1516-0001-0002.dcm.png,"there are opacities in the left lung , subsegmental atelectasis . opacities overlying the left lung base on the frontal reflect epicardial fat and overlying breast tissue . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size is at the upper limits of normal . there are diffuse degenerative changes of the spine . "
310,322_IM-1521-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . chronic appearing interstitial markings the lungs are normally inflated and clear . degenerative changes of the spine . 
311,323_IM-1526-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . right lung calcified densities are unchanged from prior and indicate old granulomatous disease . otherwise , the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
312,324_IM-1534-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
313,325_IM-1539-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
314,326_IM-1546-2002.dcm.png,the lungs are clear . heart size and mediastinal contours are normal . no osseous abnormalities . 
315,327_IM-1552-1001.dcm.png,"there is stable , mild cardiomegaly with normal caliber pulmonary vasculature . there are grossly intact sternotomy and mediastinal surgical clips . there is no focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
316,328_IM-1560-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
317,329_IM-1571-1004003.dcm.png,stable borderline enlarged cardiac contour . calcified mediastinal lymph xxxx . prominent right paratracheal stripe . emphysema . no active pulmonary disease . mild spondylosis . 
318,330_IM-1577-0001-0002.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . "
319,331_IM-1584-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
320,332_IM-1588-1001.dcm.png,"there are are streaky retrocardiac left lower lobe opacities , in the correct clinical setting this could represent a pneumonia . there is no pneumothorax or pleural effusion . the cardiac silhouette is within normal limits . "
321,333_IM-1594-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . lungs are mildly hyperexpanded . heart size and pulmonary vascularity within normal limits . 
322,334_IM-1600-1001.dcm.png,unknown
323,335_IM-1606-1001.dcm.png,a left-sided hemodialysis catheter is in with its distal tip at the right atrium . the cardiac silhouette and mediastinal contours are within normal limits . there is no focal opacity . there is no pneumothorax . no large pleural effusion . 
324,336_IM-1613-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
325,337_IM-1622-1001.dcm.png,"minimal opacities at the posterior sulci . a few septal lines of the left lateral sulcus . otherwise , the lungs are clear with granulomas and sulci . heart size upper normal thin lv contour . unfolded calcified aorta . t-spine small osteophytes . "
326,338_IM-1628-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . the patient was shielded . "
327,339_IM-1635-1001.dcm.png,unknown
328,340_IM-1644-4004.dcm.png,"heart size moderately enlarged , stable mediastinal contours . lateral view curvilinear densities over the heart suggestive of coronary artery stents . diaphragm eventration . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
329,341_IM-1648-1001.dcm.png,"two-view chest . both lungs are clear and expanded . heart and mediastinum normal . right foot . hindfoot , midfoot , forefoot are intact with no fractures or bone destruction . "
330,342_IM-1655-0001-0001.dcm.png,"the lungs and pleural spaces show no acute abnormality . stable left upper lobe calcified granuloma . heart size is mildly enlarged , pulmonary vascularity within normal limits . mild tortuosity of the descending thoracic aorta . "
331,343_IM-1658-1001.dcm.png,"heart size and mediastinal contour are normal . pulmonary vascularity is normal . is not diffuse interstitial prominence , which has chronic appearance . cannot exclude early pulmonary edema . two airspace consolidation or effusion . are osteopenic . no visible pneumothorax . "
332,344_IM-1664-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
333,345_IM-1672-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . degenerative changes of the thoracic spine . 
334,346_IM-1680-12012.dcm.png,frontal ( on two cassettes ) and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . no focal airspace consolidation or pleural effusion . 
335,346_IM-1680-4004.dcm.png,frontal ( on two cassettes ) and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . no focal airspace consolidation or pleural effusion . 
336,347_IM-1686-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . there are some minimal degenerative changes of the thoracic spine . evidence of chronic granulomatous disease . "
337,348_IM-1690-1001.dcm.png,heart size and mediastinal contour normal . lungs are clear . pulmonary vascularity normal . no pleural effusions or pneumothoraces . minimal degenerative changes thoracic spine . 
338,349_IM-1697-1001.dcm.png,the heart size is enlarged . the aorta is tortuous . the pulmonary vasculature appears normal . lungs are otherwise clear bilaterally . no pleural effusions or pneumothorax . no bony abnormalities . 
339,350_IM-1705-0001-0001.dcm.png,normal cardiomediastinal contours . no pneumothorax or large pleural effusions . left basilar patchy opacities . small hiatal hernia . 
340,351_IM-1712-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . lungs are hyperexpanded . minimal scarring in both lower lobes . heart size and pulmonary vascularity within normal limits . stable mild tortuosity of the descending thoracic aorta . 
341,352_IM-1718-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the trachea is midline . no focal pulmonary consolidation . no pneumothorax . no pleural effusion . minimal degenerative changes of the thoracic spine . 
342,353_IM-1726-1001.dcm.png,and lateral chest examination was obtained . there is improvement in bilateral pulmonary edema with mild residual . there is minimal right-sided pleural effusion . heart silhouette is not enlarged . there is calcified mediastinal lymph xxxx . there is no pneumothorax
343,354_IM-1731-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the lungs are clear . 
344,355_IM-1739-1001.dcm.png,"lung volumes are low . prominent increased interstitial markings in both lungs are unchanged in the interval . bullae are present both upper lobes , right worse than left . no pleural air collections . heart size normal . "
345,356_IM-1744-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
346,357_IM-1753-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . the right heart appears obscured and there are streaky right medial basilar airspace opacities , possibly due to airspace disease or atelectasis . otherwise , no focal consolidation , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
347,358_IM-1759-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . limbus vertebra noted within the partial visualized lumbar vertebral body . 
348,359_IM-1768-1001.dcm.png,heart size is upper limits of normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
349,360_IM-1776-1001.dcm.png,unknown
350,361_IM-1783-1001.dcm.png,lungs remain clear and expanded . heart and mediastinum normal . 
351,362_IM-1791-1001.dcm.png,unknown
352,363_IM-1798-4004.dcm.png,normal cardiomediastinal contours . no focal consolidation or pleural effusions . no pneumothorax . 
353,364_IM-1804-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
354,365_IM-1812-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
355,366_IM-1820-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
356,367_IM-1826-1001.dcm.png,the lungs are clear . no focal airspace consolidation . no pleural effusion or pneumothorax . heart size is within normal limits . 
357,368_IM-1832-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
358,370_IM-1848-1001.dcm.png,"heart size and cardiomediastinal contours are normal . lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . osseous structures are grossly intact . "
359,371_IM-1852-1001.dcm.png,the lungs are clear . there is hyperinflation . calcification is seen over the anterior mediastinum a calcified lymph node at is not identified on the pa projection . the heart is normal . arthritic changes the spine are seen . 
360,372_IM-1858-4004.dcm.png,left retrocardiac airspace disease with blunted posterior costophrenic on lateral view suggesting small pleural effusion . normal heart size . right picc is unchanged with tip at the caval atrial junction . 
361,373_IM-1864-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
362,374_IM-1868-1001.dcm.png,unknown
363,375_IM-1874-1001.dcm.png,"the cardiac silhouette , upper mediastinum and pulmonary vasculature are within normal limits . there is no acute air space infiltrate , pleural effusion or pneumothorax . "
364,376_IM-1883-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no non-calcified nodules are identified . 
365,377_IM-1889-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
366,378_IM-1895-4001.dcm.png,unknown
367,379_IM-1903-4004.dcm.png,there has been interval placement of a dual-lumen dialysis catheter with the distal tip projected over the right atrium . moderate cardiomegaly is identified . there is mild calcification of the transverse xxxx . airspace opacities are identified with bilateral pleural effusions . 
368,380_IM-1911-2001.dcm.png,"the examination consists of supine and crosstable lateral radiographs of the chest . external monitor leads the thorax . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
369,382_IM-1927-1001.dcm.png,"stable , normal cardiac size , mediastinum , and central pulmonary vasculature . marked bullous emphysematous changes and traction bronchiectasis , again most notable involving the bilateral upper lobes . stable prominent ovoid opacity ( 4 . 3 x 2 . 8 xxxx ) a large left upper lobe xxxx , reflecting a superimposed aspergilloma-as more readily demonstrated on the previous ct chest study from xxxx . no areas of alveolar airspace consolidation are identified . no evidence of pleural effusion or pneumothorax . "
370,383_IM-1932-1001.dcm.png,"normal heart size . no focal air space consolidation , pneumothorax , pleural effusion , or pulmonary edema . anterior osteophytes of the thoracic spine . "
371,385_IM-1948-1001.dcm.png,unknown
372,386_IM-1954-4004.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . bronchovascular crowding without typical findings of pulmonary edema . "
373,387_IM-1962-1001.dcm.png,heart size is normal . there is left hilar enlargement with partial opacification of the left upper lobe suggestive of hilar mass with obstructive atelectasis . questionable small right midlung nodule . negative for pneumothorax or pleural effusion . bony thorax is unremarkable . 
374,388_IM-1968-1001.dcm.png,"cardiomegaly is unchanged . stable superior mediastinal contour with tortuous calcified aorta . normal pulmonary vascularity . no focal air space consolidation , pleural effusion , or pneumothorax . no acute bony abnormality . changes of prior right mastectomy . "
375,389_IM-1973-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . there is a stable calcified granuloma in the right lower lobe . a hiatal hernia is present that is unchanged from the prior study . are grossly unremarkable . "
376,390_IM-1979-1001.dcm.png,heart size and vascularity are normal . mild tortuosity of the aorta . no focal airspace disease or effusion . degenerative change of the spine . no pneumothorax . 
377,391_IM-1986-1001.dcm.png,low lung volumes . heart size normal . no focal airspace consolidations . no pneumothorax or effusions . 
378,392_IM-1993-1001.dcm.png,"lungs are clear . no focal consolidation , effusion , or pneumothorax . interval resolution of left effusion . central venous dialysis catheter unchanged in position . heart and mediastinal contours are normal . osseous structures intact . "
379,393_IM-2002-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , pleural effusion , or pneumothorax is identified . no acute osseous abnormality identified . "
380,394_IM-2010-1001.dcm.png,there is a large airspace opacity in the right lower and middle lobes . there is no pneumothorax . heart size is normal . soft tissue and bony structures unremarkable . 
381,395_IM-2019-1001.dcm.png,the cardiac and mediastinal silhouettes are unremarkable . the lungs are well expanded and clear . there are no focal air space opacities . there is no pneumothorax or effusion . there are calcified hilar lymph suggesting prior granulomatous disease . the bony structures of the thorax are intact with no evidence of acute osseous abnormality . 
382,396_IM-2024-2002.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . there are minimal degenerative changes of the spine . 
383,397_IM-2030-1001.dcm.png,there is a 7 nodular density at the left lung base . lungs are otherwise clear . the ct scan without iv contrast could be performed for further evaluation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the thoracic spine . 
384,398_IM-2039-1001.dcm.png,"no focal consolidation , pneumothorax or definite pleural effusion . heart size and pulmonary vascularity within normal limits , no mediastinal widening characteristic in appearance of vascular injury . right paratracheal calcifications suggest a previous granulomatous process . no acute osseous injury demonstrated . "
385,399_IM-2043-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
386,400_IM-2050-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . stable small right basilar calcified granuloma . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
387,401_IM-2051-1001.dcm.png,mediastinal contours are normal . blunting of the left costophrenic xxxx . increased interstitial opacities . . there is no pneumothorax or large pleural effusion . 
388,402_IM-2051-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
389,403_IM-2052-2001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax . no effusions . multiple old right-sided rib fractures again noted . 
390,404_IM-2052-1001.dcm.png,artifact in the region of the central upper abdomen . no focal areas of consolidation . no pleural effusions . no evidence of pneumothorax . heart size within normal limits . osseous structures intact . 
391,405_IM-2053-1001.dcm.png,"rotated with low lung volumes . question left atrial enlargement , appreciated on lateral view . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . "
392,406_IM-2054-1001.dcm.png,"heart size normal . no pneumothorax , large pleural effusion , or focal airspace disease . bony structures appear intact . calcified right hilar nodules consistent with chronic granulomatous disease . "
393,407_IM-2054-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
394,408_IM-2054-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated . small bilateral pleural effusions are seen . 
395,409_IM-2055-2001.dcm.png,"redemonstration of interstitial opacities , consistent with patient's history of pulmonary fibrosis . unchanged calcified granulomas at the left greater than right hilum , and in the pretracheal region . no pneumothorax , pleural effusion or focal airspace consolidation . cardiomediastinal size is the upper limits of normal . pulmonary vasculature is normal . intact . "
396,410_IM-2056-1002.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . there is a mild levoscoliosis of the thoracic spine . there is mild widening of the right acromioclavicular joint which may be postsurgical or posttraumatic in xxxx . 
397,411_IM-2056-1001.dcm.png,there is some minimal patchy opacity in left base which may represent atelectasis or scarring . the lungs are otherwise clear . the heart and mediastinum are normal for age . there is some arthritic changes of the skeletal structures and there has been previous rotator repair on the right . 
398,412_IM-2056-2001.dcm.png,"bilateral emphysematous again noted and lower lobe fibrotic changes . postsurgical changes of the chest including cabg procedure , stable . stable valve artifact . there are no focal areas of consolidation . no large pleural effusions . no evidence of pneumothorax . degenerative changes noted of the visualized thoracic spine . nodular right lower lobe opacity , nipple xxxx . contour abnormality of the posterior aspect of the right 7th rib again noted , stable . "
399,413_IM-2056-1001.dcm.png,unknown
400,414_IM-2057-1001.dcm.png,normal heart size . clear lungs . multilevel degenerative disc disease with mild dextrocurvature near the thoracolumbar junction . 
401,415_IM-2058-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are grossly clear . bilateral breast prostheses are noted . 
402,416_IM-2059-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
403,417_IM-2060-1001.dcm.png,"stable calcified granulomas . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . "
404,418_IM-2061-2001.dcm.png,"stable enlargement of the cardiac silhouette , stable mediastinal and hilar contours , surgical clips and cabg markers . stable densities in the left base compatible with scarring or chronic subsegmental atelectasis . no focal alveolar consolidation , no definite pleural effusion seen . right hilar calcifications suggest a previous granulomatous process . no typical findings of pulmonary edema . "
405,419_IM-2062-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
406,420_IM-2064-1001.dcm.png,"mediastinal contours are within normal limits . heart size is within normal limits . no focal consolidation , pneumothorax or pleural effusion . no bony abnormality . vague density in right mid lung , related to scapular tip and superimposed ribs . not visualized on lateral exam . "
407,421_IM-2064-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable . negative for pneumoperitoneum . "
408,422_IM-2065-5001.dcm.png,unknown
409,423_IM-2066-0001-0003.dcm.png,"there is a left subphrenic crescentic lucency , this is concerning for pneumoperitoneum . there are low lung volumes and bilateral moderate to large pleural effusions with bibasilar atelectasis/airspace disease that are larger in size in comparison to the prior exam . no pneumothorax . heart size upper limits of normal . the left central venous catheter tip overlies the lower svc . the feeding tube has been placed in the interval and extends below the diaphragm and below the xxxx-of-view . "
410,425_IM-2068-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
411,426_IM-2069-4004.dcm.png,normal heart size . tortuosity of the thoracic aorta . the lungs are free of any focal airspace disease . there is no pneumothorax or pleural effusion . degenerative changes are present in the spine . 
412,427_IM-2070-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
413,428_IM-2070-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no evidence of tuberculous disease . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . "
414,429_IM-2070-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there is no definite evidence of acute fracture . "
415,430_IM-2071-1001.dcm.png,lungs are clear . no focal infiltrate or effusion . no pneumothorax . heart and mediastinal contours within normal limits . visualized osseous structures intact . 
416,431_IM-2072-1001.dcm.png,the heart size is normal . cardiomediastinal silhouette is normal in contour . the lungs are clear bilaterally . lateral views obscured by patient body habitus . there is no evidence of apical disease . are unchanged from previous exam and appear normal . thoracic spine shows osteophyte formations at several levels . 
417,432_IM-2072-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . cholecystectomy clips overlie the right upper quadrant . no acute bone abnormality . "
418,433_IM-2073-1001.dcm.png,unknown
419,434_IM-2074-1001.dcm.png,"sternotomy appear intact . borderline heart size . aortic calcification noted . calcified mediastinal lymph unchanged . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . there is hyperexpansion of the lungs with flattening of the diaphragms . degenerative changes are present in the spine . "
420,435_IM-2075-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
421,436_IM-2076-1001-0002.dcm.png,unknown
422,437_IM-2077-1001.dcm.png,"there are postoperative changes of sternotomy . there is cardiomegaly . the contour of the ascending aorta is prominent , consistent with known ascending aortic aneurysm . the lungs appear clear . no focal airspace consolidation . no pleural effusion or pneumothorax . there are minimal degenerative changes of the spine . "
423,438_IM-2078-1001.dcm.png,unknown
424,439_IM-2078-1001.dcm.png,unknown
425,440_IM-2078-5005.dcm.png,heart size is within normal limits . emphysematous changes . focal pleural thickening in the left apex is scarring . atherosclerotic calcifications of the aortic xxxx . there is no focal infiltrate . no pneumothorax or pleural effusion . 
426,441_IM-2078-1001.dcm.png,"mediastinal contours are normal . heart size is within normal limits . multiple scattered calcified pulmonary nodules , sequela of prior granulomatous disease . otherwise lungs are clear . . there is no pneumothorax or large pleural effusion . no bony abnormality . "
427,442_IM-2078-1001.dcm.png,the lungs remain hyperexpanded . no infiltrates or masses . heart and mediastinum are normal . 
428,443_IM-2078-1001.dcm.png,"heart size and mediastinal contour within normal limits . no focal airspace consolidation , pneumothorax , or large pleural effusion . degenerative changes of thoracic spine . "
429,444_IM-2079-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
430,445_IM-2079-1001.dcm.png,unknown
431,446_IM-2080-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
432,448_IM-2080-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
433,449_IM-2080-1001.dcm.png,cardiac silhouette within normal limits . no edema or airspace consolidation . no pneumothorax . no pleural effusion . 
434,450_IM-2082-1001.dcm.png,no focal consolidation . no pneumothorax . no pleural effusions . heart size normal . cardio mediastinal silhouette is unremarkable . 
435,451_IM-2082-1001.dcm.png,on the right there is marked narrowing of the hip joint space uniformly throughout . osteophyte formation is present with some sclerosis and subchondral cyst formation vertically along the superior acetabulum and femoral head . i do not see evidence for fracture or destructive process . ap view of the femur shows no femoral destructive process or other significant abnormality . for of the left hip shows near-complete obliteration of the joint space with severe subchondral sclerosis and cystic formation in both the superior acetabulum and superior aspect of the femoral head . no fracture or destructive process is identified . surgical markers were in the images and left hip for the purpose of surgical planning . pa and lateral chest show the lungs to be clear . there may be some hyperinflation . no pleural effusion is identified . the heart is normal in size . there are calcified mediastinal lymph xxxx . the skeletal structures appear normal . 
436,452_IM-2083-1001.dcm.png,the lungs appear clear . no evidence of focal pneumonia . the heart and pulmonary are normal . there is suture material at the left apex suggesting prior lung surgery . in the pleural spaces are clear . mediastinal contours appear normal . 
437,453_IM-2084-1001.dcm.png,unknown
438,454_IM-2085-1001.dcm.png,there is stable mild cardiac enlargement . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
439,455_IM-2086-4004.dcm.png,"there are low lung volumes with associated bronchovascular crowding and basilar subsegmental atelectasis . there is stable prominence of the right cardiac silhouette . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . there are stable chronic degenerative changes of the thoracic spine . "
440,456_IM-2087-1001.dcm.png,"pa and lateral radiograph the chest demonstrate stable cardiomediastinal silhouette . no focal consolidation , large pleural effusion , or pneumothorax is identified . evidence of prior granulomatous disease . visualized osseous structures appear intact . "
441,457_IM-2088-1001-0001.dcm.png,"there is a calcified granuloma left midlung . there is round density within the anterior segment of the right upper lobe . there are prominent interstitial opacities which may represent changes associated with fibrosis . heart size is normal . no pneumothorax . anterior segment of upper lobe , rounded focal density . could be lung nodule . "
442,458_IM-2089-1001.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . bony overlap in the lung apices could obscure a small pulmonary nodule . 
443,459_IM-2090-2001.dcm.png,"the cardiac and mediastinal contours are normal . the lungs are well-inflated and clear . there is no focal consolidation , pneumothorax or effusion . no acute bony abnormalities are seen . no radiopaque foreign bodies are present . "
444,460_IM-2090-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . mild tortuosity of the thoracic aorta , unchanged"
445,461_IM-2090-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
446,462_IM-2090-1001.dcm.png,mild cardiomegaly . mild unfolding of the thoracic aorta . no focal air space opacity . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . 
447,463_IM-2091-1001.dcm.png,there is a approximately 4 cm opacity with one margin and the other ill-defined in the lateral lower left lung is seen on the pa view . this is not definitely seen on the lateral view . there is no pneumothorax or pleural effusion . the cardiac silhouette is within normal limits . there are t-spine osteophytes . there is no pneumothorax or pleural effusion . there are calcified hilar lymph there
448,464_IM-2092-12012.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there is eventration of the right hemidiaphragm . degenerative changes are present in the spine . 
449,465_IM-2093-0001-0002.dcm.png,normal cardiomediastinal contours . right lower lung patchy opacities . small right pneumothorax . small right pleural effusion . 
450,466_IM-2094-2002.dcm.png,"normal heart size . mild tortuosity of the aorta . no pneumothorax , pleural effusion or suspicious airspace opacity . mild levoscoliosis of the lumbar spine . "
451,468_IM-2096-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . there is a 10 nodule in the right apex projecting between the third and fourth posterior ribs . lungs are hyperexpanded . heart size and pulmonary vascularity within normal limits . scattered densities throughout the chest from prior gunshot wound . chronic blunting of the costophrenic xxxx . healed right 10th and left 9th posterolateral rib fracture . 
452,469_IM-2097-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal airspace opacity to suggest a pneumonia . there are scoliotic changes of the thoracolumbar spine . there degenerative changes of the spine . "
453,470_IM-2099-3001.dcm.png,"the cardiac and mediastinal contours are within normal limits . the lungs are well-inflated and clear . there is no focal consolidation , pneumothorax , or effusion . the bony structures of the thorax are unremarkable . "
454,471_IM-2099-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild pectus excavatum deformity is noted . the lungs are clear . 
455,472_IM-2100-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . stable postoperative and degenerative changes of the xxxx . stable degenerative disc disease of the thoracic spine . 
456,473_IM-2101-1001.dcm.png,unknown
457,474_IM-2101-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
458,475_IM-2101-1001.dcm.png,frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal pulmonary vasculature and central airways . no focal airspace consolidation or pleural effusion . 
459,476_IM-2101-1001.dcm.png,the lungs are clear . no pleural effusion is identified . the heart is normal . there are calcifications of the aortic xxxx . the skeletal structures are normal . 
460,477_IM-2101-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
461,478_IM-2101-1001-0002.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
462,479_IM-2102-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
463,480_IM-2104-1001.dcm.png,unknown
464,481_IM-2105-1001.dcm.png,unknown
465,482_IM-2106-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . gastrostomy tube is noted . "
466,483_IM-2107-1001.dcm.png,there is flattening of hemidiaphragms . there are prominent interstitial markings . there is no focal consolidation to suggest pneumonia . there are atherosclerotic institutions of the aorta . the heart is of the first limits of normal size . no pneumothorax or pleural effusion . 
467,484_IM-2108-1001.dcm.png,the heart is normal in size . the mediastinum is stable . there is again significant thoracolumbar rotatory scoliosis . the aorta is atherosclerotic . the lungs are hypoinflated but clear . 
468,485_IM-2109-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
469,486_IM-2110-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . scar in the right lateral midlung . adjacent focal pleural thickening is noted . chronic blunting of both lateral costophrenic xxxx . heart size and pulmonary vascularity within normal limits . tortuous , ectatic thoracic aorta , unchanged . sternotomy intact . "
470,487_IM-2110-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
471,488_IM-2110-1001.dcm.png,"broken of the 4xxxx xxxx , similar to the prior study . stable multiple surgical clips in the left hilar area . stable cardiomediastinal silhouette . pulmonary vasculatures are within normal limits . no focal consolidation , pleural effusion or pneumothorax . unremarkable bony structure . "
472,489_IM-2110-1001.dcm.png,"cardiomediastinal silhouette is a within normal limits . no focal consolidation , pneumothorax , or pleural effusion . multiple granulomas . no acute bony abnormalities . "
473,490_IM-2110-1001.dcm.png,patient is slightly rotated . normal heart size . there is no pulmonary edema . there is no focal consolidation . there are no of a pleural effusion . there is no evidence of pneumothorax . 
474,491_IM-2111-1001.dcm.png,"cardiomediastinal silhouette is stable and within normal limits . there is improved lung volumes bilaterally with persistent bibasilar atelectatic opacities , without focal consolidation , pneumothorax , or effusion . no acute bony abnormality identified . "
475,492_IM-2112-2002.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . are intact . "
476,493_IM-2113-1001.dcm.png,stable appearing bilateral calcified lymph xxxx . the cardiac silhouette and mediastinal contours are within normal limits . no focal opacity . no large pleural effusion . there is no pneumothorax . 
477,494_IM-2114-1001.dcm.png,"heart size within normal limits . mediastinal contours unremarkable . pulmonary vascularity is normal . right lung is clear . opacities left lung base may represent atelectasis versus scarring . no focal consolidation . no pleural effusion , no pneumothorax . bony structures unremarkable . "
478,495_IM-2114-1001.dcm.png,heart size within normal limits . streaky airspace disease is demonstrated on the lateral examination . no pneumothorax or pleural effusion . 
479,496_IM-2114-1001.dcm.png,"chest . lungs are clear and expanded . heart normal . left knee . no change marked narrowing , large osteophyte formation , multiple synovial osteochondromas . "
480,497_IM-2114-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
481,498_IM-2115-1001.dcm.png,"large medial right upper lobe mass lesion , measuring approximately 5 . 8 cm x 6 . 0 cm in diameter . no pneumothorax . no pleural effusions . lungs clear . heart size within normal limits . degenerative changes thoracic spine . "
482,499_IM-2116-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . 
483,501_IM-2120-1001.dcm.png,unknown
484,502_IM-2120-1001.dcm.png,"chest . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . abdomen . no pneumoperitoneum . there is a normal bowel pattern . air and stool visible throughout the entire large colon including the rectum . no abnormally dilated small bowel loops . no evidence for intussusception or small bowel obstruction . no pathologic calcifications over the abdomen or pelvis . are without fracture or destructive lesion , though there are mild degenerative changes throughout the lumbar spine . small hiatal hernia is not as well demonstrated on this exam . "
485,503_IM-2121-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
486,504_IM-2122-1001.dcm.png,"stable cardiomediastinal silhouette . stable opacity in the left base , scarring or atelectasis . rounded calcified density in the left lung base , calcified granuloma . no consolidation . no pleural effusion or pneumothorax . stable degenerative changes of the spine . "
487,505_IM-2123-1001.dcm.png,"no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . heart size and pulmonary vascularity within normal limits , visualized osseous structures appear intact . "
488,506_IM-2124-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
489,507_IM-2125-1001.dcm.png,"no airspace disease , effusion or noncalcified nodule . normal heart size and mediastinum . visualized of the chest are within normal limits . "
490,508_IM-2125-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable . 
491,509_IM-2125-1001.dcm.png,two left-sided chest tubes again noted . interval improved aeration of the left lung compared to prior . interval improvement in left lung pleural fluid . right lung clear . endotracheal tube noted with tip approximately 4 . 5 cm above the carina . left internal jugular central venous catheter with tip approximating the high svc . no evidence of pneumothorax . 
492,510_IM-2126-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
493,511_IM-2127-1001.dcm.png,hyperaerated lungs with flattened hemidiaphragms . normal heart size . increased retrosternal airspace . no focal infiltrate . no pneumothorax or pleural effusion . 
494,512_IM-2127-1001.dcm.png,there are no focal areas of consolidation . no suspicious bony opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . mild degenerative changes of the thoracic spine . 
495,513_IM-2128-1001.dcm.png,"there is prominence of the right heart xxxx , consistent with right atrial enlargement . a density is demonstrated on the frontal view with exaggerated posterior projection of the cardiac silhouette , suggesting left atrial enlargement . the cardiac silhouette is overall enlarged . the mediastinal contours are otherwise within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . mild pulmonary hyperexpansion . mild left apical pleural thickening . moderate degenerative changes of the thoracic spine . 19/33 . "
496,514_IM-2129-2001.dcm.png,the heart size is normal . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
497,515_IM-2129-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
498,516_IM-2130-1001.dcm.png,normal heart . calcified right hilar granulomas . no focal infiltrate . midline trachea . 
499,517_IM-2130-2002.dcm.png,unknown
500,518_IM-2131-1001.dcm.png,"stable normal cardiac size and contour , unremarkable mediastinal silhouette . normal pulmonary and interstitium . lungs clear , no airspace disease , pleural effusion , or pneumothorax . no active/acute cardiopulmonary disease . "
501,519_IM-2131-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . intact . "
502,519_IM-2131-2001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . intact . "
503,520_IM-2131-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . pulmonary vasculature is normal . old rib fractures , healed . stable increased density overlying the lower mediastinum , unchanged , is due to hiatal hernia seen on examination . "
504,521_IM-2132-4004.dcm.png,"low lung volumes with bronchovascular crowding . no focal alveolar consolidation , no definite pleural effusion seen . heart size within normal limits for technique , no typical mediastinal widening of vascular injury . no pleural line of pneumothorax . "
505,522_IM-2133-1002001.dcm.png,there is hyperinflation of the lungs . a small area scarring is seen in the left cardiophrenic region . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
506,525_IM-2136-1001.dcm.png,"no focal consolidation , no definite pleural effusion seen . exaggerated kyphosis with increased ap dimension of the thorax , curvilinear density projected over the right anterior 3rd and 4th ribs beyond which lung markings are seen skin fold artifact . mild aortic ectasia/tortuosity , no typical mediastinal widening to suggest vascular injury . contour irregularity of the lateral right 9th rib of indeterminate age . "
507,527_IM-2137-1001.dcm.png,"cardiac and mediastinal appear normal . no visible pneumothorax , focal airspace opacity , or pleural effusion is seen . no visible free air under the diaphragm . the osseous structures appear intact . "
508,529_IM-2137-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . chronic appearing right mid clavicle injury . visualized bony structures otherwise unremarkable . 
509,530_IM-2139-1001.dcm.png,unknown
510,531_IM-2140-1001.dcm.png,"right thorax volume loss with some degree of left-to-right mediastinal shift . relative hyperlucency of left lung , compensatory hyperinflation . diminutive right hilar silhouette , compatible with absence of right pulmonary artery , as noted on prior ct . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
511,532_IM-2140-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
512,533_IM-2140-1001.dcm.png,there is prominence of the superior mediastinum which may be partially due to patient's known thyroid mass . there is increased tortuosity of the descending thoracic aorta . cardiac silhouette is within normal limits . lungs are clear without focal opacification . no pneumothorax or pleural effusion . there is scoliotic curvature the thoracic spine . no acute bone abnormality . 
513,534_IM-2141-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . left perihilar scarring is noted in the upper lobe . streaky opacities in the retrocardiac region reflect mild subsegmental atelectasis . there is no focal infiltrate or pleural effusion . 
514,535_IM-2142-1001.dcm.png,there is s-shaped thoracolumbar scoliosis . there are t-spine osteophytes . opacity in the left lower lobe represents atelectasis or scarring . there is no pneumothorax . there is no large pleural effusion . the cardiomediastinal silhouette is within normal limits . there is no lobar pneumonia . there are calcified hilar lymph xxxx . 
515,536_IM-2143-1001.dcm.png,"no acute osseous abnormality . the soft tissues are within normal limits . normal cardiomediastinal silhouette and hilar contours . no focal area of consolidation , pleural effusion , or pneumothorax . "
516,537_IM-2143-1001.dcm.png,there is scattered calcified granulomas . the lungs are otherwise grossly clear . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
517,538_IM-2144-4004.dcm.png,frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . no focal airspace consolidation or pleural effusion . 
518,539_IM-2145-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
519,540_IM-2146-4004.dcm.png,the heart size is within normal limits . mild streaky opacities are present in the left lung base . an accessory azygos fissure is noted . no pleural effusion or pneumothorax . 
520,541_IM-2147-1001.dcm.png,cardiomediastinal contour and pulmonary vascularity within normal limits . clear lungs . no pleural effusion or pneumothorax . mild age-indeterminate anterior wedging of a lower thoracic or upper lumbar vertebra on lateral view . left-sided rib deformities consistent with old fractures . mild degenerative changes about the thoracolumbar junction . 
521,543_IM-2148-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
522,544_IM-2148-1001.dcm.png,heart and mediastinum are normal . no focal consolidation . no pleural effusion or pneumothorax . bony structures are intact . 
523,545_IM-2149-1001.dcm.png,lung volumes are xxxx . opacities are present in both lung bases . a hiatal hernia is present . heart and pulmonary are normal . 
524,546_IM-2150-1001.dcm.png,unknown
525,547_IM-2151-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . there are degenerative changes throughout the thoracic spine . 
526,548_IM-2152-1001.dcm.png,"cardiomediastinal silhouette is within normal limits in overall size and appearance . central vascular markings are symmetric and within normal limits . the lungs are normally inflated with no focal airspace disease , pleural effusion or pneumothorax . no acute bony abnormality . stable scarring in the right lung apex . "
527,549_IM-2153-1001.dcm.png,"stable appearance of the left upper lung lobe with scarring , volume loss , and pleural thickening . cardiomediastinal silhouette is within normal limits normal appearance , similar to prior . volume loss in the left lung , stable . right lung is clear . there is no focal airspace disease , pleural effusion , or pneumothorax . mild scarring at the right apex . no acute bony abnormality . "
528,550_IM-2154-1001.dcm.png,unknown
529,551_IM-2154-1001.dcm.png,"lungs are hyperinflated with flattening of the diaphragms and increased ap chest diameter , compatible with emphysema . there is no evidence of focal infiltrate , pneumothorax , pleural effusion , or identified mass lesion . there is normal cardiomediastinal contours . "
530,552_IM-2155-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are t-spine osteophytes . calcified granuloma in the right apex . 
531,553_IM-2155-2001.dcm.png,normal heart size and mediastinal contours . scattered calcified granulomas . hyperexpanded lungs . no focal airspace disease . no pneumothorax or pleural effusion . degenerative changes in the spine without acute bony abnormalities . 
532,554_IM-2155-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
533,555_IM-2156-1001.dcm.png,heart size normal . no focal airspace consolidations . no pneumothorax or effusion . degenerative changes in the midthoracic spine . 
534,556_IM-2156-1001-0002.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
535,557_IM-2157-2001.dcm.png,the cardiomediastinal silhouette is normal in size and appearance . there is no pneumothorax or pleural effusion . the lung zones are clear . there are no bony abnormalities
536,558_IM-2158-0001-0001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . there are a few scattered calcified granulomas . there is no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . 
537,559_IM-2159-1001.dcm.png,unknown
538,560_IM-2161-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . the lungs are clear without areas of focal consolidation . no pneumothorax or large pleural effusion . no acute bone abnormality . 
539,562_IM-2163-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
540,563_IM-2164-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . cardiac silhouette is at top limits of normal . aortic and mediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . partially visualized orif involving the left proximal humerus . deformity of the left distal clavicle compatible with remote xxxx . no displaced rib fractures on this chest examination . "
541,564_IM-2165-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . there is right upper lobe airspace disease . . there is a rounded nodular opacity in the left upper lung measuring approximately 7 mm which may represent further sequela of infectious process versus other pathology . osseous structures are within normal limits for patient age . 
542,565_IM-2166-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
543,567_IM-2167-1001.dcm.png,"heart size upper normal but stable . mediastinal contours within normal limits . . minimal right middle lobe atelectasis . no focal airspace consolidation , pleural effusion , or pneumothorax . degenerative endplate changes of the spine . "
544,568_IM-2168-1001.dcm.png,"heart size normal . tortuous aorta . calcified hilar lymph sequela of prior granulomatous disease . hyperinflated lungs . the otherwise lungs are clear . the bilateral apices are partially excluded from the xxxx-of-view . there is the interval fixation of the right humeral fracture , appears grossly intact . osteopenia . exaggerated kyphosis of the thoracic spine . "
545,569_IM-2169-0001-0002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the left hemidiaphragm remains elevated . right base densities are again noted which appear improved . previously seen left pleural effusion has resolved . there continues to be some left base opacities which may represent atelectasis . surgical clips and suture lines are noted in the mediastinum . an air-fluid level is seen in the upper right abdomen immediately below the right hemidiaphragm . extensive pleural densities are present on the right which may represent localized fluid or pleural thickening . no definite pneumothorax is seen . 
546,570_IM-2170-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . 
547,571_IM-2170-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
548,572_IM-2170-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
549,573_IM-2171-12012.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . sternotomy and surgical clips are again seen . the cardiomediastinal contours are unchanged . there is a background of marked centrilobular emphysema . streaky opacities in the lung bases may represent atelectasis or scarring . there is no consolidation , pleural effusion or pneumothorax . "
550,573_IM-2171-4004.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . sternotomy and surgical clips are again seen . the cardiomediastinal contours are unchanged . there is a background of marked centrilobular emphysema . streaky opacities in the lung bases may represent atelectasis or scarring . there is no consolidation , pleural effusion or pneumothorax . "
551,575_IM-2173-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . stable calcified granuloma in the left lung . 
552,576_IM-2174-1001.dcm.png,exam limited by patient rotation . mild rightward deviation of the trachea . stable cardiomegaly . unfolding of the thoracic aorta . persistent right pleural effusion with adjacent atelectasis . low lung volumes . no focal airspace consolidation . there is severe degenerative changes of the right shoulder . 
553,577_IM-2175-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
554,578_IM-2176-1001.dcm.png,"normal cardiomediastinal silhouette and hilar contours . the lungs are clear without focal area of consolidation , pleural effusion , or pneumothorax . findings compatible with prior granulomatous disease . the visualized are intact without acute osseous abnormality . "
555,579_IM-2176-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
556,580_IM-2177-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . atherosclerotic calcifications of the aortic are noted . the lungs are clear . 
557,581_IM-2178-1001.dcm.png,frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . no focal airspace consolidation or pleural effusion . 
558,582_IM-2179-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
559,583_IM-2180-1001.dcm.png,unknown
560,584_IM-2181-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures intact . 
561,585_IM-2181-1001.dcm.png,"there are prominent epicardial fat pads , unchanged from prior . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there is atherosclerosis of the aortic xxxx . unchanged streaky opacities in the bilateral costophrenic sulci represent chronic scarring or atelectasis . "
562,586_IM-2182-1001.dcm.png,the heart size is moderately enlarged . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . again noted is and left midlung airspace opacity atelectasis . there is left basilar opacity atelectasis as well . there is improved right midlung opacity . there are mild degenerative changes of the spine . sternotomy are intact . extensive atherosclerotic disease . 
563,587_IM-2182-2001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no interval change in the appearance of the opacities in the bilateral lower lobes . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
564,588_IM-2183-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
565,589_IM-2183-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
566,590_IM-2185-2001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . there is right middle lobe airspace disease , may reflect atelectasis or pneumonia . no pleural effusion . no pneumothorax . elevated right hemidiaphragm . "
567,591_IM-2186-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . the lungs are clear without areas of focal consolidation . there is a calcified granuloma within the left lung base . there is suggestion of a deep sulcus sign on the right . no definite pleural line of pneumothorax visualized . there is age-indeterminate wedging of several midthoracic vertebral bodies . 
568,592_IM-2186-12012.dcm.png,unknown
569,593_IM-2186-1001.dcm.png,"no acute cardiopulmonary abnormality . extensive degenerative changes of the thoracic spine . mildly enlarged heart . tortuous aorta . aortic calcifications . no focal area of consolidation , pleural effusion or pneumothorax . "
570,594_IM-2187-1001.dcm.png,there are t-spine osteophytes . there calcified costochondral cartilages . there is loss of disc of a midthoracic vertebral body . there are streaky opacities in both lung bases which may represent atelectasis or scarring . no pneumothorax . the heart is borderline enlarged . 
571,595_IM-2187-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . "
572,596_IM-2188-26001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the right chest tip is visualized in the mid svc . there is no pneumothorax . the lungs are clear . 
573,598_IM-2190-12012.dcm.png,unknown
574,599_IM-2191-1001.dcm.png,unknown
575,600_IM-2192-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . calcified left hilar lymph xxxx/granulomas . no focal consolidation , pneumothorax or large pleural effusion . old fracture , right mid clavicle . "
576,601_IM-2192-1001.dcm.png,right dual-lumen internal jugular central venous catheter seen with tip overlying the cavoatrial junction . heart size at the upper limits of normal . low lung volumes with bronchovascular crowding . patchy bibasilar air airspace opacities right greater than left . no visualized pneumothorax . prominence of the mediastinum consistent with history of sarcoid . 
577,602_IM-2192-1001.dcm.png,unknown
578,603_IM-2193-1001.dcm.png,unknown
579,604_IM-2193-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . picc line is in xxxx . the tip is in the upper right atrium . 
580,605_IM-2194-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . small nodular opacity left upper lobe may represent early infiltrate . the lungs are otherwise clear . there is no pleural effusion . 
581,606_IM-2195-1001.dcm.png,"sternotomy are in and intact . normal cardiomediastinal silhouette . the bilateral costophrenic are excluded from the image on the pa view . lungs are clear without focal areas of consolidation , pleural effusion , or pneumothorax . are intact without acute osseous abnormality . mild degenerative changes throughout the thoracic spine . "
582,607_IM-2196-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . scattered bilateral calcified pulmonary nodules . no acute bone abnormality . "
583,608_IM-2196-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . there is an old healed fracture through the right 8th rib . 
584,609_IM-2197-1001.dcm.png,stable cardiomediastinal silhouette . pulmonary vascularity is within normal limits . lungs are expanded and clear of airspace disease . negative for pneumothorax or pleural effusion . are grossly intact . 
585,610_IM-2197-1001.dcm.png,unknown
586,611_IM-2198-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . pulmonary hypoinflation with bronchovascular crowding . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute , displaced rib fractures . "
587,612_IM-2199-1001.dcm.png,"interval performance of anterior cervical spinal fusion , intact without complicating features . there is stable cardiomegaly , with persistent bibasilar opacities atelectasis and/or infiltrate . no focal consolidations , pneumothorax , or pleural effusions . the visualized osseous structures demonstrate mild multilevel degenerative disc disease of the thoracolumbar spine , without acute osseous abnormality . "
588,613_IM-2200-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
589,614_IM-2200-4001.dcm.png,unknown
590,615_IM-2200-1001.dcm.png,"there is no focal consolidation , pleural effusions , or pneumothoraces . scattered calcified nodules compatible with granulomatous disease . cardiomediastinal silhouette is within normal limits . no masses or suspicious nodules . are unremarkable . "
591,616_IM-2200-1001.dcm.png,"there are broken 1st and 3rd-5xxxx xxxx . normal cardiomediastinal silhouette . pulmonary vasculatures are within normal limits . left-sided aortic xxxx . central airways are xxxx . no focal consolidation , pleural effusion or pneumothorax . left hemidiaphragm is mildly elevated . interposition of the colon in the left upper quadrant . "
592,617_IM-2200-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum are stable with normal sized heart . degenerative changes in the spine . 
593,618_IM-2201-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is no pulmonary nodule identified . there is a left humerus prosthesis partly demonstrated . "
594,619_IM-2202-1002.dcm.png,"there has been interval sternotomy with intact midline sternotomy xxxx . the heart is near top normal in size with unfolding of the aorta . the lungs are grossly clear with no focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are grossly normal . "
595,620_IM-2202-1001.dcm.png,"there is no focal consolidation , pleural effusion , or pneumothorax . stable left lower lobe scarring . normal heart size and pulmonary vascularity . there are degenerative changes of the thoracic spine noted . "
596,621_IM-2203-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are mild degenerative changes of the spine . "
597,622_IM-2204-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
598,623_IM-2205-2002.dcm.png,"the heart is normal in size . the mediastinum is stable . atherosclerotic calcifications of the aorta . there is again a pleural based density in the right lung base , related to subpleural fat . the appearance is stable from multiple previous studies . the lungs are clear . there is no pleural effusion . "
599,624_IM-2206-1001.dcm.png,the cardiac contours are normal . the lungs are hyperinflated with flattening of the diaphragms and tapering of the distal pulmonary vasculature . there is no focal consolidation . thoracic spondylosis . mild dextroscoliosis of the spine . prior anterior cervical fusion . 
600,626_IM-2206-1001.dcm.png,the heart size is on the upper limits of normal . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
601,626_IM-2206-3001.dcm.png,the heart size is on the upper limits of normal . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
602,627_IM-2207-1001.dcm.png,stable cardiomegaly . thoracic aortic atherosclerotic calcifications are noted . there is a prominence of the pulmonary vasculature . no consolidating airspace disease is seen . no pleural effusion or pneumothorax . 
603,628_IM-2208-4001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . cardiac silhouette at the upper limits of normal in size . tortuous ectatic aorta . the aortic is near 5 cm in diameter . there is a retrocardiac left paraspinal bulge concerning for a descending thoracic aortic aneurysm . there is biapical scarring . no focal airspace consolidation or pleural effusion . spine spondylitic changes . 
604,629_IM-2209-1001.dcm.png,"the cardiac and mediastinal contours are within normal limits . lungs are well-inflated and clear . there is no focal consolidation , pneumothorax or effusion . no acute bony abnormalities are seen . "
605,630_IM-2211-1001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours are normal . patient status post sternotomy and cabg . 
606,631_IM-2212-1001.dcm.png,"the heart is normal in size . the mediastinum is within normal limits . dual-lumen right ij catheter is identified without pneumothorax . the lungs are moderately hypoinflated with bibasilar opacities adjacent atelectasis . there is ill-defined density overlying the anterior left 5th rib , possibly healing deformity versus superimposition of structures . "
607,632_IM-2213-1001.dcm.png,"cardiac and mediastinal silhouette are unremarkable . lungs are clear . no focal consolidation , pneumothorax , or pleural effusion identified . and soft tissue are unremarkable . "
608,633_IM-2213-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . there are multilevel degenerative changes of the spine . 
609,634_IM-2214-2001.dcm.png,unknown
610,635_IM-2215-1001.dcm.png,unknown
611,636_IM-2215-1001.dcm.png,heart size is normal . right lung is clear . granulomatous disease in the bilateral . subsegmental atelectasis in the left lower lung . no pneumothorax . no pleural effusion . 
612,637_IM-2216-4001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
613,638_IM-2217-1001.dcm.png,unknown
614,638_IM-2217-3001.dcm.png,unknown
615,639_IM-2218-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
616,640_IM-2219-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . vascular calcification is noted . 
617,641_IM-2220-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . mild dextrocurvature of the spine again noted . "
618,642_IM-2221-0001-0001.dcm.png,unknown
619,643_IM-2222-1001.dcm.png,unknown
620,643_IM-2222-2001.dcm.png,unknown
621,644_IM-2223-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
622,645_IM-2224-1001.dcm.png,"heart size and mediastinal contours appear normal limits . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . degenerative changes of the spine . "
623,646_IM-2225-1001.dcm.png,clear lungs . normal heart mediastinum . no pneumothorax . no pleural effusion . no acute bony abnormality . nipple ring on left . 
624,648_IM-2226-4004.dcm.png,"cardiomediastinal size and contour is grossly normal for ap technique . there is a calcified granuloma in the right lower lobe . the lungs are mildly hypoinflated but grossly clear of focal airspace disease , pneumothorax or pleural effusion . no acute , displaced fractures are demonstrated . "
625,649_IM-2227-1001.dcm.png,the heart size is normal . mediastinal contours are within normal limits . postsurgical changes of left hemithorax are stable . skin have been removed since prior study study . the left apical pneumothorax has resolved . there are mild chronic opacities in the left lung base with probable small residual effusion . the right lung is grossly clear . 
626,650_IM-2228-4001.dcm.png,"rotated examination . tortuous aorta . moderate right-sided pleural effusion , small left sided . no pneumothorax . mixed nodular interstitial opacities distributed through bilateral lungs , right greater than left . cardiomediastinal silhouette is mildly enlarged . obliquely oriented left humeral neck fracture , transverse , with 5 mm displacement of the distal fragment . limited evaluation of the aorto iliac stent . no cavitary lesion to suggest . active tuberculosis . large hiatal hernia . "
627,651_IM-2229-1001.dcm.png,heart size is within normal limits . there are surgical clips in the left mediastinum . there is no pneumothorax . there is a small left pleural effusion . abnormal convexity within the mediastinum represents adenopathy which is better demonstrated on the prior xxxx . 
628,652_IM-2229-1001.dcm.png,heart size is normal . no pneumothorax . no large pleural effusions . no focal airspace opacities . 
629,653_IM-2230-1001.dcm.png,heart size and vascularity normal . lungs clear . no effusions or pneumothorax . limited degenerative change of the spine
630,654_IM-2231-1001.dcm.png,lungs are clear . heart size normal . the are unremarkable . 
631,655_IM-2231-1001.dcm.png,normal heart size and mediastinal contours . the lungs are hyperinflated but clear . no pneumothorax or pleural effusion . no acute bony abnormalities . 
632,656_IM-2232-84570001.dcm.png,unknown
633,657_IM-2233-0001-0001.dcm.png,heart is at the upper limits of normal size . lungs are clear without focal infiltrates . no pneumothorax or pleural effusion . normal pulmonary vascularity . 
634,658_IM-2234-1001.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
635,659_IM-2235-1001.dcm.png,heart size within normal limits . tortuous aorta . low lung volumes with no focal consolidations . no pneumothorax or effusion . moderate degenerative disc disease in the midthoracic spine . 
636,660_IM-2237-0001-0002.dcm.png,"no focal consolidation , suspicious pulmonary opacity or definite pleural effusion . heart size and pulmonary vascularity within normal limits . stable mediastinal contour . calcified hilar lymph xxxx . visualized osseous structures unremarkable . "
637,661_IM-2238-2002.dcm.png,spinal stimulator in xxxx . lungs are clear without focal airspace disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the thoracic spine . 
638,662_IM-2238-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . "
639,663_IM-2239-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . no acute bony or soft tissue abnormality . "
640,664_IM-2240-1001.dcm.png,"heart and mediastinal contours are unremarkable . the pulmonary vasculature is normal in appearance . the lung parenchyma is clear , without focal infiltrate . there are no pleural effusions , and there is no pneumothorax . the visualized bony structures are grossly unremarkable . no displaced rib fractures . right nipple ring noted . "
641,665_IM-2240-1001.dcm.png,unknown
642,666_IM-2241-1001.dcm.png,the heart is mildly enlarged . the aorta is atherosclerotic and ectatic . chronic parenchymal changes are noted with mild scarring and/or subsegmental atelectasis in the right lung base . no focal consolidation or significant pleural effusion identified . costophrenic are blunted . 
643,667_IM-2241-1001.dcm.png,"there has been interval removal of right-sided central venous catheter . enteric tube is again noted , coursing below the diaphragm the tip of which is seen projecting over the expected location of the body of the stomach . the cardiomediastinal silhouette is normal , unchanged from prior . low lung volumes , causing streaky bibasilar atelectasis and bronchovascular crowding . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
644,668_IM-2242-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
645,669_IM-2242-2001.dcm.png,cardiomegaly is present . the upper lobe pulmonary vascularity appears mildly prominent consistent with pulmonary venous hypertension . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there is eventration of the right hemidiaphragm . bony changes of renal osteodystrophy are noted . 
646,670_IM-2244-85049001.dcm.png,the heart is top normal in size . the mediastinum is stable . the aorta is atherosclerotic . there are mild chronic changes without focal consolidation . no pleural effusion is seen . 
647,671_IM-2245-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . there are calcified mediastinal perihilar pulmonary nodules consistent with sequela of old granulomatous infection . no acute lung infiltrates . aortic appear unremarkable . there is no effusion or pneumothorax . 
648,672_IM-2246-1001.dcm.png,unknown
649,674_IM-2247-1001.dcm.png,there are low lung volumes . there is bronchovascular crowding . heart and mediastinal contours within normal limits . no focal infiltrate or effusion . no pneumothorax . visualized osseous structures intact . 
650,675_IM-2247-1001.dcm.png,the cardiac contours are normal . cardiac valve replacement . the lungs are clear . thoracic spondylosis . 
651,676_IM-2248-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . 
652,677_IM-2249-1001.dcm.png,picc line catheter tip in the right atrium . heart is not enlarged . trachea and bronchi appear normal . lungs are mildly under expanded . no pneumothorax . there are small areas of patchy density in the left lower lung xxxx . there is a larger area of patchy density in the right mid and lower lungs with right-sided pleural effusion . 
653,679_IM-2251-1001.dcm.png,"sternotomy are intact and unchanged position from prior exam . lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
654,680_IM-2251-1001.dcm.png,2 images . small centrally calcified granuloma within the lateral right lung base . otherwise the lungs are clear . heart size is normal . no evidence for pleural effusion or pneumothorax . 
655,681_IM-2252-0001-0002.dcm.png,heart size and pulmonary vascularity appear within normal limits . right picc line is in xxxx . the tip has moved into the left innominate vein . there has been interval development of several ill-defined focal opacities in the left and right mid lung zones . no pneumothorax or pleural effusion is seen . 
656,682_IM-2253-1001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . the pleural spaces are clear . surgical clips and suture material are noted in the right hilar region suggesting prior lung surgery . the mediastinal contours are stable . 
657,683_IM-2254-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
658,684_IM-2254-1001.dcm.png,unknown
659,685_IM-2254-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal and unchanged compared to prior examination . tubular densities overlying the heart are coronary artery stents . there are small round calcific densities in the bilateral lobes which are unchanged from prior exam and represent sequelae from old granulomatous disease . otherwise lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
660,686_IM-2254-1001.dcm.png,cardiomegaly with unfolded aorta . there is no pulmonary edema . there is no focal consolidation . there are no of a large pleural effusion . there is no evidence of pneumothorax . 
661,687_IM-2255-1001.dcm.png,the cardiac silhouette is at the upper limits of normal for size . there are low lung volumes with bronchovascular crowding . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . minimal degenerative endplate changes of the thoracic spine . 
662,688_IM-2256-1001.dcm.png,kub . centered over the mid abdomen there are multiple air-filled dilated loops of small bowel measuring the of which measure up to about 3 . 7 cm in diameter . there is also an extremely dilated in the same region which measures 5 . 9 cm in diameter . there is extensive soft tissue pannus . prior abdominal surgery . chest . there is left basilar opacity . no visualized pneumothorax . the heart size is normal . there is mild elevation of the left hemidiaphragm . there are no large pleural effusions . there is thickening of the fissure . 
663,689_IM-2257-1001.dcm.png,three noncalcified lung nodules are present in the left lower lobe . the largest measures 3 . 5 mm in diameter . another nodule is present near the right hilum . it is approximately 2 cm in diameter . the and mediastinum appear normal . heart size normal . 
664,690_IM-2258-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
665,691_IM-2258-1001.dcm.png,"the heart and cardiomediastinal silhouette are stable in size and contour . there is no focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
666,692_IM-2258-1001.dcm.png,the lungs are clear . there are calcified granulomas . heart size is normal . no pneumothorax . there are endplate changes in the spine . 
667,693_IM-2259-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are without focal consolidation , pneumothorax , or pleural effusion . grossly unchanged appearance of calcified hilar lymph and scattered calcified granulomas . stable degenerative changes in the spine . "
668,694_IM-2260-4001.dcm.png,the cardiac silhouette and pulmonary vascularity are normal . the lungs are clear . there is no evidence of pleural effusion . postoperative changes are noted in the mediastinum and lower cervical spine . 
669,695_IM-2261-1001.dcm.png,there is persistent mild elevation right hemidiaphragm . there is suggestion of subtle patchy opacities in lower lung bilaterally . this is to be similar to scan . the heart is normal . the aorta is calcified and tortuous . the skeletal structures show scoliosis and arthritic changes . 
670,696_IM-2261-1001-0002.dcm.png,this study is limited secondary to patient body habitus . the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
671,697_IM-2262-2002.dcm.png,"there is obscuration of the left hemidiaphragm , suggesting left retrocardiac airspace disease . this is not identified in the lateral view , which is limited by rotation . no evidence for effusion . "
672,698_IM-2263-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . t-spine osteophytes . "
673,699_IM-2263-1001.dcm.png,"stable enlargement of the cardiac silhouette , stable mediastinal contours . increased interstitial markings in the central lungs and bases , right greater than left . opacity on the lateral view over the heart also present on the previous exam suggesting chronic subsegmental atelectasis or scarring . no definite pleural effusion seen . "
674,700_IM-2265-4004.dcm.png,"the heart is normal in size and contour . there is a calcified granuloma in the right lower lung . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . osteopenia with mild degenerative changes of the thoracic spine is noted . "
675,701_IM-2266-1001.dcm.png,"there are postsurgical and postradiation changes of the left lung with a spiculated , hyperdense scar in the left upper thorax . there is a loss of lung volume on the left due to postsurgical change . deviation towards the left . right lung is hyperexpanded . the right lung is clear . heart size and vascularity within normal limits . "
676,702_IM-2267-1001.dcm.png,"the left lung is grossly clear . the right lung demonstrates a large right pleural effusion with associated atelectatic collapse of the right middle lobe and partial collapse of the right lower lobe . opacities are seen within the aerated right lung , subsegmental atelectasis . no focal consolidation or pneumothorax identified . no acute osseous abnormality . cardio mediastinal silhouette is stable compared to prior examinations . "
677,703_IM-2267-1001.dcm.png,unknown
678,704_IM-2267-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
679,705_IM-2268-1001.dcm.png,unknown
680,706_IM-2269-4004.dcm.png,"stable cardiomediastinal silhouette with normal heart size and aortic ectasia/tortuosity . no focal alveolar consolidation , no definite pleural effusion seen . mild bronchovascular crowding without typical findings of pulmonary edema . distal clavicle shortening also present on the previous exam , possibly posttraumatic or postsurgical . "
681,707_IM-2270-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
682,708_IM-2271-1001.dcm.png,"no pleural effusion , pneumothorax or focal airspace opacities . cardiomediastinal silhouette is within normal limits . the trachea is midline . no free subdiaphragmatic air . the included osseous structures are grossly intact . "
683,709_IM-2272-3001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . aortic vascular calcifications . normal pulmonary vascularity . fracture-dislocation of the right shoulder . bone demineralization . scoliosis which is possibly positional . 
684,710_IM-2273-1001.dcm.png,stable normal cardiac size and contour with unremarkable mediastinal silhouette . normal pulmonary xxxx . no active airspace disease/infiltrate . no pleural effusion or pneumothorax . calcified granuloma right upper lobe . 
685,711_IM-2273-1001.dcm.png,calcified granulomas are noted within the lung bases and stable compared with prior study . the cardiac silhouette and mediastinal contours are within normal limits . there is no pneumothorax . there is no focal opacity . no large pleural effusion . is minimal retrolisthesis of two lower thoracic vertebral bodies . 
686,712_IM-2274-0001-0001.dcm.png,the lungs are mildly hyperexpanded . there is no focal airspace consolidation to suggest pneumonia . no pleural effusion or pneumothorax . normal heart size and mediastinal contour . 
687,712_IM-2274-0001-0003.dcm.png,the lungs are mildly hyperexpanded . there is no focal airspace consolidation to suggest pneumonia . no pleural effusion or pneumothorax . normal heart size and mediastinal contour . 
688,713_IM-2275-1001.dcm.png,"central venous catheter tip in the right atrium . heart size and shape are normal . trachea and bronchi appear normal . the lungs are reasonably well expanded . there and patchy nodular densities in both lower lung more marked on the right than the left . there is scattered areas of bronchial wall thickening , well-seen in the left upper lobe . there is loss of definition of part of the left heart xxxx . no effusions no pneumothorax . "
689,714_IM-2276-1001.dcm.png,stable scarring near the right lung apex along the lateral aspect . lungs are otherwise clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
690,714_IM-2276-3001.dcm.png,stable scarring near the right lung apex along the lateral aspect . lungs are otherwise clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
691,715_IM-2277-2001.dcm.png,"there is chronic asymmetric elevation of the right hemidiaphragm . compared with the prior study , there is mildly increased streaky airspace disease in the right lung base . hilar prominence appears stable . there is no pneumothorax or large pleural effusion . heart size is stable and grossly normal . there no acute bony findings . "
692,716_IM-2278-0001-0001.dcm.png,unknown
693,717_IM-2279-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
694,718_IM-2280-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . there is mild scoliosis of the spine . 
695,719_IM-2280-1001.dcm.png,unknown
696,720_IM-2281-1001.dcm.png,"the cardiac silhouette , upper mediastinum and pulmonary vasculature are within normal limits . there is no acute air space infiltrate , pleural effusion or pneumothorax . "
697,721_IM-2282-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
698,722_IM-2282-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
699,723_IM-2283-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is bilateral basilar opacity compatible with atelectasis . there are somewhat low lung volumes . there is a calcified right hilar lymph node . "
700,725_IM-2285-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . lungs are clear without areas of focal consolidation . no pneumothorax or large pleural effusion . 
701,725_IM-2285-3001.dcm.png,the cardiomediastinal silhouette is within normal limits . lungs are clear without areas of focal consolidation . no pneumothorax or large pleural effusion . 
702,726_IM-2286-2001.dcm.png,"heart size within normal limits . prominent right perihilar density consistent with lymphadenopathy , previously partially demonstrated abdomen and pelvis xxxx , xxxx . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . tips noted . "
703,727_IM-2287-1001.dcm.png,unknown
704,728_IM-2287-1001.dcm.png,"in the interval , a 2 cm diameter nodule has developed in the posterior segment of the left lower lobe . it is not calcified . no other infiltrates or masses in the lungs . heart and pulmonary are normal . are normal . "
705,729_IM-2288-1001.dcm.png,"no focal consolidation , pneumothorax , or pleural effusion identified . however , there is a 1 . 7 cm nodular opacity within the right hilum , which may represent partially calcified granuloma or lymphadenopathy . scattered calcified granulomas also seen . heart size is upper limit normal . no acute bony abnormality . "
706,730_IM-2290-1001.dcm.png,unknown
707,731_IM-2291-1001.dcm.png,"the lungs are clear , and without focal air space opacity . the cardiomediastinal silhouette is normal in size and contour . there is no pneumothorax or large pleural effusion . "
708,732_IM-2292-1001-0002.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion or pneumothorax . there is hyperexpansion of the lungs . mild degenerative changes are present in the spine . "
709,733_IM-2293-0001-0002.dcm.png,"there is a dual-lumen right internal jugular central venous catheter , the distal tip projects over the right atrium . there is no apparent pneumothorax . there is no focal lung opacity or pleural effusion . there is stable right upper lung lucency . the cardiopulmonary mediastinal silhouettes are stable . the visualized osseous structures appear within normal limits . "
710,734_IM-2293-0001-0002.dcm.png,no pneumothorax . heart size is normal . no large pleural effusions . no focal airspace consolidation . 
711,735_IM-2294-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
712,735_IM-2294-3001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
713,736_IM-2295-1001-0001.dcm.png,unknown
714,737_IM-2295-1001.dcm.png,"heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no acute bony changes . "
715,738_IM-2296-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
716,739_IM-2296-1001.dcm.png,and lateral views of the chest were obtained xxxx/xxxx . the lung volumes are low normal . the lungs are clear and there are no pleural effusions . the mediastinum and pulmonary are normal . the bony elements are not remarkable . 
717,740_IM-2297-2001.dcm.png,the heart and mediastinum are stable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
718,741_IM-2297-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no acute bony changes . "
719,742_IM-2298-1001.dcm.png,"focal opacity in the medial right lung base seen on the frontal view . no definite pleural effusion . stable cardiomediastinal silhouette with normal heart size , no typical findings of pulmonary edema . "
720,743_IM-2299-1001.dcm.png,unknown
721,744_IM-2299-1001.dcm.png,"the heart size and pulmonary vascularity appear within normal limits . left xxxx-a-xxxx is in xxxx . no pleural effusion or pneumothorax is seen . right upper lobe area of dense opacity is seen in the medial right apex . on a previous outside scan ( xxxx ) , the right upper lobe was consolidated . comparison to the from that exam shows this opacity to have decreased . no films were available , however , for direct comparison . "
722,745_IM-2299-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
723,746_IM-2300-3001.dcm.png,there is stable scarring or atelectasis in the left midlung . the lungs are otherwise grossly clear . the heart size is near the upper limits of normal . mediastinal silhouette is normal . there is no pneumothorax or pleural effusion . t-spine osteophytes are noted . 
724,748_IM-2302-1001.dcm.png,"mediastinal contours are within normal limits . heart size is within normal limits . no focal consolidation , pneumothorax or pleural effusion . "
725,749_IM-2302-1001.dcm.png,negative for cardiac enlargement . negative for vascular congestion . bilateral granulomas are seen scattered throughout the lungs . negative for pneumothorax . negative for focal air space consolidation . some minimal streaky opacity at the bilateral bases relates to subsegmental atelectasis . 
726,750_IM-2304-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . mild degenerative change is seen within the midthoracic spine . there is no visible free intraperitoneal air under the diaphragm . 
727,751_IM-2305-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
728,752_IM-2305-1001.dcm.png,the lungs appear clear . scattered calcified granulomas are stable as are calcified mediastinal lymph xxxx . the heart and pulmonary are normal . mediastinal contours are normal . pleural spaces are clear . 
729,753_IM-2306-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are mild degenerative changes of the spine . "
730,754_IM-2306-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
731,755_IM-2306-1001.dcm.png,unknown
732,756_IM-2307-1001.dcm.png,"normal cardiomediastinal silhouette . no airspace consolidation , pneumothorax , pleural effusion , or pulmonary edema . no acute bony abnormality . "
733,756_IM-2307-3001.dcm.png,"normal cardiomediastinal silhouette . no airspace consolidation , pneumothorax , pleural effusion , or pulmonary edema . no acute bony abnormality . "
734,757_IM-2308-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are unchanged . normal pulmonary vascularity . stable postsurgical changes of the lower cervical spine . 
735,758_IM-2309-1001.dcm.png,normal heart size . clear lungs . no large pleural effusion . no pneumothorax . 
736,759_IM-2309-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . there is ectasia of the thoracic aorta . no pleural effusion is identified . 
737,760_IM-2310-1001.dcm.png,"there is minimal hyperexpansion and hyperlucency of the lungs suggestive of chronic lung disease , without focal consolidation , pneumothorax , or effusion identified . opacity in the left subsegmental atelectasis . cardiomediastinal silhouette is grossly stable and within normal limits , with mild tortuosity and atherosclerosis of the thoracic aorta . multilevel degenerative disc disease of the thoracolumbar spine noted without acute bony abnormality . "
738,761_IM-2310-1001.dcm.png,lung volumes are low . no focal infiltrates . heart size normal . 
739,762_IM-2310-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified lymph are present . 
740,763_IM-2310-1001.dcm.png,there are scattered calcified granulomas . no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . 
741,764_IM-2311-3001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute abnormality . "
742,765_IM-2311-2001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . right xxxx-a-xxxx remains in xxxx . 
743,766_IM-2311-1001.dcm.png,unknown
744,767_IM-2312-1001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , pneumothorax . no acute bony abnormality . no lymphadenopathy . "
745,767_IM-2312-3001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , pneumothorax . no acute bony abnormality . no lymphadenopathy . "
746,768_IM-2313-1001.dcm.png,normal heart size and mediastinal contours . no focal air space opacities . no pleural effusion . visualized osseous structures are unremarkable . 
747,769_IM-2314-1001.dcm.png,clear lungs . no pneumothorax . no pleural effusion . normal heart . mild degenerative changes of the thoracic spine without acute bony abnormality . prominent right epicardial fat
748,770_IM-2316-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
749,771_IM-2316-2001.dcm.png,"heart size and pulmonary vascularity within normal limits . no focal infiltrate , pneumothorax or pleural effusion identified . "
750,772_IM-2317-0001-0002.dcm.png,"sternotomy and numerous mediastinal clips appear stable in position . there is aortic atherosclerotic calcification . the thoracic aorta is tortuous . stable widening of the upper mediastinum . stable cardiomegaly . prominent mitral annular calcification demonstrated on the lateral view . no pneumothorax , pleural effusion or airspace consolidation . appear intact . "
751,773_IM-2318-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . right suprahilar calcified lymph xxxx . right lung base calcified granuloma . no focal consolidation , pneumothorax or large pleural effusion . mildly hyperexpanded lungs . negative for acute bone abnormality . "
752,774_IM-2318-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are mildly hyperexpanded but clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
753,776_IM-2319-1001.dcm.png,"cardiomediastinal silhouette is within normal limits in size and appearance . pulmonary vascularity is unremarkable . there are prominent coarse interstitial markings throughout the lungs , with more focal streaky bibasilar opacities , seen only on the frontal xxxx , atelectasis . negative for focal airspace disease or consolidation . negative for pneumothorax or pleural effusion . limited evaluation reveals the are grossly intact . "
754,777_IM-2320-4004.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is tortuous . no focal areas of pulmonary consolidation . no pneumothorax . no large pleural effusion . mild degenerative changes and osteopenia of the thoracic spine . overlying ekg leads . 
755,778_IM-2321-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . stable calcified granulomas . bony thorax is unremarkable . "
756,779_IM-2321-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
757,780_IM-2323-2001.dcm.png,"heart size is upper limits of normal . mediastinal contours and pulmonary vascularity are within normal limits . there is no focal infiltrate or suspicious pulmonary opacity . no pneumothorax or pleural effusion . there is a lucency along the peripheral right lung base , secondary to a skin fold . no acute bony findings . "
758,781_IM-2323-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
759,782_IM-2324-1001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . no focal airspace consolidation or pleural effusion . 
760,783_IM-2325-1001.dcm.png,there is a calcified granuloma in the left upper lung zone . the lungs are otherwise clear . there is hyperinflation . the heart and mediastinum are normal . the skeletal structures and soft tissues are normal for age . 
761,784_IM-2325-1001-0002.dcm.png,normal heart size . tortuous calcified aorta . scattered granulomas . no lobar pneumonia . probable post your recess effusions . kyphotic degenerated osteopenic thoracic spine . 
762,785_IM-2325-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
763,786_IM-2326-1001.dcm.png,unknown
764,788_IM-2328-1001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . probable old lateral right rib fractures . 
765,790_IM-2329-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . surgical clips are in the epigastrium of the abdomen . 
766,791_IM-2330-1001.dcm.png,stable cardiomediastinal silhouette . tortuous aorta . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
767,792_IM-2330-1001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
768,793_IM-2330-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . oval sclerotic density projecting over the inferior right glenoid may represent synovial osteochondromatosis or cortical xxxx . this is unchanged 31 17 xxxx . the remaining osseous structures and visualized upper abdomen are unremarkable in appearance . "
769,794_IM-2331-1001.dcm.png,normal heart size and mediastinal contours . lungs are clear . there is no pneumothorax or pleural effusion . postoperative changes seen in the left humerus . no acute bony abnormalities . 
770,795_IM-2331-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
771,796_IM-2332-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
772,797_IM-2332-1001.dcm.png,the heart size is enlarged . tortuous aorta . otherwise the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
773,798_IM-2332-1001.dcm.png,the heart is not enlarged . lungs are clear . no pleural effusion . 
774,799_IM-2333-1001.dcm.png,heart size and mediastinal contours are within normal limits . no focal airspace consolidation . no suspicious pulmonary nodules or masses . no evidence of pleural effusion or pneumothorax . no evidence of acute osseous abnormality . 
775,800_IM-2334-4004-0001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size is enlarged , pulmonary vascularity within normal limits . marked tortuosity of the thoracic aorta . there are advanced degenerative changes of the glenohumeral joints bilaterally with bone-on-bone articulation , remodeling of the glenoid , and extensive subchondral cystic change . no displaced rib fractures are visualized . diffuse osteopenia of the thoracic spine with a mid thoracic and several lower thoracic deformities , age-indeterminate . there is an air-fluid level in the middle mediastinum , most secondary to a large hiatal hernia . "
776,800_IM-2334-4004-0002.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size is enlarged , pulmonary vascularity within normal limits . marked tortuosity of the thoracic aorta . there are advanced degenerative changes of the glenohumeral joints bilaterally with bone-on-bone articulation , remodeling of the glenoid , and extensive subchondral cystic change . no displaced rib fractures are visualized . diffuse osteopenia of the thoracic spine with a mid thoracic and several lower thoracic deformities , age-indeterminate . there is an air-fluid level in the middle mediastinum , most secondary to a large hiatal hernia . "
777,801_IM-2335-1001.dcm.png,"heart is normal in size . no focal consolidation , pleural effusion or pneumothorax . no acute or destructive bone abnormality . "
778,802_IM-2336-4004.dcm.png,unknown
779,804_IM-2338-2001.dcm.png,"low lung volumes are noted . allowing for technical factors the heart size is normal . the mediastinum is unremarkable . there is increased bilateral predominantly perihilar interstitial opacity , consistent with pulmonary edema . there is no pneumothorax or pleural effusion . the are unremarkable . "
780,805_IM-2339-1001.dcm.png,the lungs are clear . no focal airspace consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . mild degenerative changes of the spine . 
781,806_IM-2340-0001-0002.dcm.png,"the cardiac silhouette is borderline enlarged . pulmonary vasculature is normal in caliber . nipple shadows and dense breast tissue overlie the lung bases . the lungs are grossly clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
782,808_IM-2341-2001.dcm.png,overall low lung lines . there is scarring or subsegmental atelectasis at the right lung base . in the left lower lobe there is airspace disease consistent with pneumonia . no pneumothorax . heart and mediastinum are stable given the lung volumes . degenerative changes in the spine . 
783,809_IM-2342-1001.dcm.png,"the lungs are clear , and without focal air space opacity . the cardiomediastinal silhouette is at the upper limits of normal in size but stable from prior exam . there is tortuosity of the thoracic aorta , stable . there is no pneumothorax or large pleural effusion . "
784,810_IM-2343-1001.dcm.png,"normal heart size , mediastinal and aortic contours . normal pulmonary vascularity . the lungs are clear . no focal consolidation , visible pneumothorax or large pleural effusion . scattered calcified granuloma . degenerative changes the spine . "
785,811_IM-2343-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . there is stable irregularity of the posterior left 6th rib which represents an old fracture . . "
786,812_IM-2343-1001.dcm.png,chronic bilateral emphysematous changes . the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . stable splenic artery embolism coils . 
787,813_IM-2344-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are unchanged . there are diminished lung volumes with central bronchovascular crowding . minimal atelectasis versus scarring seen in the left lung base . right lung is clear . no focal consolidation , pleural effusion , or pneumothorax identified . there are degenerative changes of the thoracic spine . "
788,814_IM-2345-1001.dcm.png,there is a calcified granuloma in the lateral left base . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are calcified left hilar lymph xxxx . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted as well as scoliosis and lumbar region . 
789,815_IM-2346-1001.dcm.png,unknown
790,817_IM-2348-0001-0002.dcm.png,there are left upper lobe opacities . lungs otherwise appear clear . no pleural effusion or pneumothorax . heart size is as is within normal limits . 
791,818_IM-2349-1001.dcm.png,heart size is stable . there is focal airspace consolidation in the lateral aspect of the right upper lobe . there is no pneumothorax or effusion . no acute bony abnormalities . 
792,819_IM-2349-1001.dcm.png,both lungs are clear and expanded area heart and mediastinum are normal . incidental note of bilateral breast implants . 
793,820_IM-2351-1001.dcm.png,there are t-spine osteophytes . small nodule projecting near the left heart is unchanged from and appears calcified . this represents a calcified granuloma . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
794,821_IM-2351-1001.dcm.png,stable heart size and mediastinal contours . no focal airspace consolidation . stable calcified granuloma in the right upper lobe . this low lung volumes . no focal airspace disease . 
795,822_IM-2352-1001.dcm.png,"the lungs remain hyperexpanded . there are persistent bilateral lower lobe opacities , subsegmental atelectasis and scarring . no focal infiltrate is identified . there is no pleural effusion or pneumothorax . normal heart size . there are minimal degenerative changes of the spine . "
796,824_IM-2354-1001.dcm.png,there are no focal areas of consolidation . no pleural effusions . no pneumothorax . heart size within normal limits . calcified granulomas . degenerative changes thoracic spine . 
797,825_IM-2355-1001.dcm.png,unknown
798,826_IM-2355-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . "
799,827_IM-2356-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . scarring and emphysematous changes noted . the lungs are grossly clear . 
800,828_IM-2357-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . there are low lung volumes , causing bibasilar atelectasis and bronchovascular crowding . there is a opacity in the left lingula . there is no pleural effusion or pneumothorax . visualized bony structures reveal no acute abnormalities . "
801,829_IM-2358-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
802,830_IM-2358-1001.dcm.png,unknown
803,831_IM-2358-4004.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . low lung volumes without focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
804,832_IM-2359-1001.dcm.png,unknown
805,833_IM-2359-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
806,834_IM-2359-1001.dcm.png,the cardiac silhouette pulmonary vascularity are normal . the lungs are clear . there is no evidence of pleural effusion or pneumothorax . mild degenerative changes are present in the spine . 
807,835_IM-2360-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . there is no pneumothorax . there is no pleural effusion . there is redemonstration of right rib deformities from old xxxx . of mild dextroscoliosis of the thoracic spine . there is no free intraperitoneal air under the diaphragm . 
808,836_IM-2360-2001.dcm.png,"the examination consists of frontal supine and lateral radiographs of the chest . frontal view is lordotic in projection . the cardiomediastinal contours are within normal limits for supine film . no focal consolidation , pleural effusion , or pneumothorax identified . there is a calcified granuloma at the left lung base . the visualized osseous structures and upper abdomen are unremarkable . "
809,837_IM-2361-1001.dcm.png,cardiomediastinal silhouette is within normal limits . lungs are clear without areas of focal consolidation . right hilar calcifications sequela of prior granulomatous disease . no pneumothorax or large pleural effusion . no acute bone abnormality . 
810,838_IM-2362-1001.dcm.png,"stable prominence of the cardiac apex , from ventricular hypertrophy . mid sternotomy again noted . no pneumothorax , significant pulmonary edema or large pleural effusions . no focal lung consolidation . clips in the right upper quadrant consistent with cholecystectomy . dextroscoliosis of the thoracolumbar spine . "
811,839_IM-2363-1001.dcm.png,heart size normal . no pleural effusions or pneumothorax . lungs are clear . soft tissues and are unremarkable . 
812,840_IM-2364-0001-0002.dcm.png,unknown
813,841_IM-2365-1001.dcm.png,"the heart is normal in size . the mediastinum is unremarkable . left upper extremity pic catheter tip overlies the distal aspect of the left clavicle within the subclavian vein . there is no pneumothorax . the lungs are mildly hyperinflated but clear . deformity of the lateral left 6th rib , old injury . "
814,842_IM-2366-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no radiodense foreign bodies noted . no acute osseous findings . 
815,843_IM-2366-1001.dcm.png,right lower lobe calcified granuloma . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . degenerative changes thoracic spine . 
816,844_IM-2367-1001.dcm.png,no pleural effusion no pneumothorax . normal cardiac contour . no focal consolidation . lungs clear bilaterally . 
817,845_IM-2367-1001.dcm.png,minimal subsegmental atelectasis posteriorly . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
818,846_IM-2368-0001-0001.dcm.png,heart size and pulmonary vascularity appears normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . callus or granulomas identified . left xxxx-a-xxxx remains in xxxx . 
819,846_IM-2368-0001-0002.dcm.png,heart size and pulmonary vascularity appears normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . callus or granulomas identified . left xxxx-a-xxxx remains in xxxx . 
820,847_IM-2369-1001.dcm.png,"the trachea is midline . the heart is slightly large . there are low lung volumes causing bronchovascular crowding . otherwise the lungs appear clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . "
821,849_IM-2371-1001.dcm.png,"normal heart size and mediastinal contours . the lungs are free of any focal airspace disease . in the left lung base , there is a 9 mm nodule that not definitively calcified . no pneumothorax or pleural effusion . no acute bony abnormalities . "
822,850_IM-2373-0001-0001.dcm.png,"stable appearance of the cardiomediastinal silhouette . there is no pneumothorax , pleural effusion , or focal airspace consolidation . "
823,853_IM-2375-1001.dcm.png,unknown
824,854_IM-2376-1001.dcm.png,the lungs appear clear . the heart and pulmonary appear normal . the pleural spaces are clear . these xxxx't contours appear normal . there is a fracture of the midthoracic vertebral body . this vertebral body does not appear sclerotic . the age of this fracture is unknown . there are healed fractures of several left anterior ribs . there is a healed left clavicle fracture . 
825,855_IM-2376-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
826,856_IM-2377-1001.dcm.png,"limited evaluation of the lateral view due to rotation and frontal view due to motion artifact . stable mild cardiomegaly . normal pulmonary vascularity . the lungs are clear . no focal consolidation , visible pneumothorax or large pleural effusions . opacities are related to overlying soft tissues . the posterior sulci are clear . degenerative changes of the spine . "
827,857_IM-2378-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
828,858_IM-2379-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . there is evidence of previous granulomatous disease . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
829,859_IM-2380-1001.dcm.png,"the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . right lower lung opacity represents combination of soft tissue overlay and minimal atelectasis . no focal airspace consolidation , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . "
830,860_IM-2381-4001.dcm.png,"chronic increased interstitial markings without evidence of focal infiltrate . bilateral apical pleural thickening . no pneumothorax . no pleural effusion . stable heart size . marked degenerative change of the xxxx , status post remote right humerus fracture . deformity of a midthoracic vertebral body , also chronic . "
831,861_IM-2382-1001.dcm.png,"stable appearance of the right aortic xxxx . normal heart size . no pneumothorax , pleural effusion or suspicious focal airspace opacity . "
832,862_IM-2383-1001.dcm.png,the parenchymal scar in the left lower lobe is unchanged in the interval . no infiltrates or masses in the lungs . heart and mediastinum are normal . 
833,863_IM-2383-1001.dcm.png,no focal consolidation . no visualized pneumothorax . the heart size is normal . no large pleural effusions . the cardiomediastinal silhouette is grossly unremarkable . 
834,863_IM-2383-3001.dcm.png,no focal consolidation . no visualized pneumothorax . the heart size is normal . no large pleural effusions . the cardiomediastinal silhouette is grossly unremarkable . 
835,864_IM-2384-1001.dcm.png,"stable cardiomediastinal silhouette with tortuous thoracic aorta . no pneumothorax , pleural effusion or suspicious focal air space opacity . stable right lung base scarring . "
836,865_IM-2385-1001.dcm.png,"cardiac silhouette is normal in size . normal mediastinal contour and pulmonary vasculature . the lungs are without focal airspace consolidation , large pleural effusion , or pneumothoraces . "
837,867_IM-2387-1001.dcm.png,"heart size near top normal , bilateral hilar fullness nonspecific in appearance , mild aortic ectasia/tortuosity . diaphragm flattening and relative apical lucencies suggestive of emphysema , and irregular interstitial markings , right greater than left . prominent left epicardial fat xxxx , no focal alveolar consolidation , no definite pleural effusion seen . atrial septal occluder artifact . mild spine curvature . "
838,868_IM-2388-1001.dcm.png,unknown
839,869_IM-2389-2001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
840,870_IM-2391-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
841,871_IM-2391-2001.dcm.png,chest . heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . pelvis . there are numerous clips overlying the pelvis and lower abdomen . nonobstructive bowel pattern . no pathologic calcifications . hip joint spaces are symmetric and normal . sacroiliac joints are unremarkable . no fractures or dislocations . 
842,872_IM-2391-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are clear . bony structures are intact . 
843,875_IM-2392-1001.dcm.png,chest . the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . left knee . the right total knee prosthesis remains in xxxx . the medial compartment is markedly narrow . large osteophytes are present on the left femur and tibial lateral plateaus . 
844,877_IM-2392-1001.dcm.png,"sternotomy appear intact . surgical clips overlying the mediastinum . mitral valve replacement seen . low lung volumes . the interstitial markings appear prominent , which may represent interstitial edema . there is mild blunting of the posterior sulcus on the lateral view , which could represent a small effusion . no pneumothorax . no acute bony abnormality . "
845,878_IM-2392-1001.dcm.png,unknown
846,879_IM-2393-12012.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
847,880_IM-2395-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
848,881_IM-2396-1001.dcm.png,the lungs are without focal air space opacity . there is no pneumothorax or large pleural effusion . the cardiomediastinal silhouette is normal in size and contour . 
849,882_IM-2397-0001-0002.dcm.png,unknown
850,883_IM-2398-1003.dcm.png,unknown
851,884_IM-2398-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . right basilar calcified granuloma noted . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
852,886_IM-2400-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
853,887_IM-2400-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
854,888_IM-2401-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
855,889_IM-2401-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
856,890_IM-2403-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are otherwise clear . bony structures are intact . 
857,891_IM-2403-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
858,892_IM-2403-1001.dcm.png,there is hyperinflation . there is some subtle scarring in the lateral right base . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
859,893_IM-2403-1001.dcm.png,unknown
860,894_IM-2404-0001-0001.dcm.png,unknown
861,896_IM-2406-1001.dcm.png,three images submitted . cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
862,897_IM-2406-1001.dcm.png,there are patchy alveolar and interstitial opacities within the lung bases bilaterally representing an infectious etiology versus chronic lung disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac silhouette is enlarged . there are atherosclerotic calcifications of the aortic xxxx . there are degenerative changes throughout the thoracic spine . 
863,899_IM-2407-1001.dcm.png,"the lungs are clear . there is no focal consolidation , pleural effusion , or pneumothorax . the heart and mediastinum are normal size and shape . and soft tissues are unremarkable . "
864,901_IM-2409-2001.dcm.png,"heart size is enlarged but stable . stable sequela prior granulomatous disease . stable sternotomy with fracture of the superior-most sternotomy xxxx . . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . degenerative endplate changes of the spine . "
865,901_IM-2409-3001.dcm.png,"heart size is enlarged but stable . stable sequela prior granulomatous disease . stable sternotomy with fracture of the superior-most sternotomy xxxx . . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . degenerative endplate changes of the spine . "
866,902_IM-2409-1001.dcm.png,the heart size of the limits of normal . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there is a calcified granuloma right midlung and posterior costophrenic sulcus . 
867,903_IM-2409-1001.dcm.png,"there is interstitial thickening bilaterally , more prominent in the bases . the cardiomediastinal silhouette is normal in size and appearance . there is hyperexpansion . no infiltrates . two bullae are seen in the right upper lung . small calcified granuloma stable from prior exam . "
868,905_IM-2410-0001-0001.dcm.png,unknown
869,906_IM-2411-1001.dcm.png,"heart size mildly enlarged , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
870,907_IM-2412-82526002.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there has been interval development of multiple healed left rib fractures . degenerative changes are present in the spine . 
871,908_IM-2413-1001.dcm.png,the lungs appear clear . there are calcified nodules projecting in the right upper lung . mediastinal contours appear normal . the heart pulmonary appear normal . pleural spaces are clear . surgical clips are identified in the right neck and left mediastinum . 
872,909_IM-2414-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
873,910_IM-2416-2001.dcm.png,the heart size is moderately enlarged . there is evidence of previous aortic valve replacement . sternotomy are grossly intact . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there are chronically increased interstitial lung markings without superimposed focal airspace disease identified . there are degenerative changes of the spine . 
874,911_IM-2417-1001.dcm.png,heart size within normal limits and cardiomediastinal contours are normal . lungs are clear bilaterally . no focal consolidations . no pleural effusions or pneumothorax . bony structures and soft tissues are unremarkable . 
875,912_IM-2417-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . heart size is normal . the cardiomediastinal silhouette is grossly unremarkable . 
876,913_IM-2417-1001.dcm.png,"heart size normal . stable cardiomediastinal silhouette . no pneumothorax , pleural effusion , or focal airspace disease . bony structures are in alignment without fracture . "
877,914_IM-2417-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . negative for focal consolidation , pneumothorax or large pleural effusion . middle lobe calcified granulomas . normal xxxx . "
878,915_IM-2418-2002.dcm.png,unknown
879,916_IM-2419-1001.dcm.png,lungs are clear without focal airspace disease . numerous calcifications are again noted . no pleural effusions or pneumothoraces . heart size is upper limits of normal . 
880,917_IM-2419-1001.dcm.png,there are stable sternotomy xxxx . the heart and mediastinal contours are unchanged . the lungs are clear without focal infiltrate . there is no effusion or pneumothorax . 
881,918_IM-2420-4004.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
882,919_IM-2421-1001.dcm.png,unknown
883,920_IM-2423-1001.dcm.png,heart size is normal . cardiomediastinal contour is normal without mediastinal widening . lungs are clear bilaterally . no pleural effusions or pneumothorax . no bony or soft tissue abnormalities . 
884,921_IM-2423-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . no pleural effusion . "
885,922_IM-2423-2001.dcm.png,the heart is slightly large . pulmonary are normal . no infiltrates . 
886,923_IM-2424-2001.dcm.png,unknown
887,925_IM-2425-2001.dcm.png,increased interstitial lung changes with superimposed pulmonary edema . cardiomegaly . negative for effusion or pneumothorax . degenerative changes of the thoracic spine . 
888,926_IM-2425-1001.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . "
889,927_IM-2425-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . stable tortuosity of the thoracic aorta . no focal consolidation , pleural effusion , or pneumothorax is identified . no acute osseous abnormality identified . "
890,928_IM-2426-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
891,929_IM-2427-1001.dcm.png,no change lung xxxx . opacities are present in the right lower lobe . no focal infiltrates . heart and mediastinum are unremarkable . aorta normal . 
892,930_IM-2429-2001.dcm.png,lung volumes are low . no focal infiltrates . pulmonary are normal . 
893,931_IM-2429-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
894,932_IM-2430-4004.dcm.png,"no gross consolidation , atelectasis or infiltrate . no pleural fluid collection or pneumothorax . cardiomediastinal silhouette is within normal limits . is intact . "
895,933_IM-2431-1001.dcm.png,change . both lungs are clear and expanded . heart and mediastinum normal . 
896,934_IM-2432-1001.dcm.png,"cardiomediastinal silhouette is within normal limits of size in appearance . pulmonary vascularity is unremarkable . there are diffuse , bilateral interstitial opacities , with b lines demonstrated . small amount of subpleural edema is demonstrated in the fissures . there is mild blunting of both posterior costophrenic sulci , which may reflect effusions . negative for pneumothorax . limited evaluation reveals the the grossly intact . "
897,935_IM-2432-1001.dcm.png,unknown
898,936_IM-2432-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
899,937_IM-2433-1001.dcm.png,normal cardiac size . normal pulmonary vasculature . no airspace disease . negative for pneumothorax . negative for acute osseous deformity . the thoracic spine has a normal appearance . 
900,938_IM-2434-1001.dcm.png,heart size and mediastinal contour normal . lungs are clear except for residuals of prior granulomatous infection . no pleural effusions or pneumothoraces . 
901,939_IM-2435-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
902,940_IM-2437-2001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . no displaced rib fractures visualized . . 
903,941_IM-2438-1001.dcm.png,"surgical at the distal left clavicle . no acute osseous abnormality . soft tissue structures are within normal limits . stable normal cardio mediastinal silhouettes and hilar structures . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . . "
904,942_IM-2438-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . vascular calcification is noted . no adenopathy is seen . 
905,943_IM-2439-5005.dcm.png,"heart size , cardiomediastinal silhouette , and pulmonary vasculature are within normal limits . there are no infiltrates , effusions , or pneumothorax . "
906,944_IM-2440-1001.dcm.png,"heart size and cardiomediastinal silhouette are normal . mild tortuosity of the aorta . low lung volumes , however lungs are grossly clear without focal airspace opacity , pleural effusion , or pneumothorax . osseous structures grossly intact . "
907,945_IM-2440-1001.dcm.png,"in the interval , consolidation has developed in the left upper lobe . also , anterior segment opacity is present . right lung remains clear . heart size is normal . "
908,946_IM-2441-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
909,947_IM-2442-2001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . limited lateral view , given overlapping silhouettes . negative for acute displaced rib fracture . "
910,948_IM-2443-1001.dcm.png,the heart is top normal in size . the mediastinum is stable . the lungs are clear . 
911,949_IM-2444-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiac silhouette is normal in size and configuration . calcified right hilar lymph xxxx . there is focal contour abnormality of the level of the inferior posterior mediastinum , may reflect focal aneurysm of the descending thoracic aorta . the lungs are well aerated . no pneumothorax , pleural effusion , or focal air space consolidation . "
912,950_IM-2446-1003002.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
913,951_IM-2447-1001.dcm.png,normal heart . clear lungs . no pneumothorax . no pleural effusion . 
914,952_IM-2447-2002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified granuloma are noted . a few opacities are present consistent with of scarring or atelectasis . 
915,953_IM-2447-1001.dcm.png,stable cardiomegaly . calcified tortuous aorta . no focal air space disease . stable chronic lung changes . no large pleural effusion or pneumothorax . diffuse degenerative changes of the thoracic spine . 
916,954_IM-2448-12001.dcm.png,unknown
917,955_IM-2449-1001.dcm.png,stable position of right central venous catheter . interval removal of nasogastric tube . heart size is normal . persistent prominent interstitial markings of the right upper lobe . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are unchanged . normal pulmonary vascularity . 
918,956_IM-2449-1001.dcm.png,status post posterior spinal fusion with stable appearance of the orthopedic xxxx . pectus carinatum . stable mild cardiomegaly and increased lung vascularity . clear lungs . 
919,957_IM-2449-1001.dcm.png,"the heart size is normal . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . there are degenerative changes within the bilaterally and left acromioclavicular joint . in the soft tissues of the right upper extremity . "
920,958_IM-2449-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
921,959_IM-2449-2001.dcm.png,the heart and mediastinal contours are stable . there is minimal patchy right lower lobe airspace disease identified . no pleural effusion or pneumothorax . 
922,960_IM-2451-4004.dcm.png,"no focal consolidation , pneumothorax or definite pleural effusion . heart size within normal limits for technique , no mediastinal widening seen . no acute osseous injury demonstrated . dextroscoliosis noted . "
923,961_IM-2452-84646001.dcm.png,"there is a opacity projecting over the left midlung , posterior on the lateral view . no pleural effusions . no evidence of pneumothorax . heart size top normal . degenerative changes thoracic spine . "
924,962_IM-2453-1002001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
925,963_IM-2454-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are minimal degenerative changes of the spine . "
926,964_IM-2454-1001.dcm.png,"in the interval , the heart size has become normal . pulmonary are normal . lungs are clear and expanded . "
927,965_IM-2455-1001.dcm.png,the lungs appear clear . heart and pulmonary appear normal . mediastinal contours are normal . pleural spaces are clear . there appears to the contrast within small colonic diverticula in the splenic flexure region . 
928,966_IM-2456-1001.dcm.png,unknown
929,967_IM-2457-2002.dcm.png,"heart size and mediastinal contours are unremarkable . there is no pneumothorax , pleural effusion , focal airspace consolidation . "
930,968_IM-2458-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
931,969_IM-2459-1001.dcm.png,"heart size upper limits of normal but stable . tortuous aorta . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
932,970_IM-2460-2001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
933,971_IM-2461-2001.dcm.png,normal heart size mediastinal contours . no focal airspace consolidation . no hyperexpansion of the lungs . no pleural effusion or pneumothorax . 
934,972_IM-2461-1001-0001.dcm.png,unknown
935,973_IM-2462-1001.dcm.png,unknown
936,974_IM-2463-1001.dcm.png,"stable cardiomediastinal silhouette . mild congestion without edema . lungs are expanded and clear of airspace disease . negative for pneumothorax or pleural effusion . redemonstrated are endplate depressions of the vertebral bodies , compatible with cell changes . "
937,975_IM-2464-1001.dcm.png,cardiac silhouette and mediastinal contours are within this . there is no opacity . there is no pneumothorax . no large pleural effusion . hyperlucent right apex with hyperinflation consistent with emphysematous changes . 
938,976_IM-2464-1001.dcm.png,lung volumes are low . no infiltrates in the lungs . no pleural air collections . sternotomy sutures and bypass graft markers are present . heart size normal . 
939,977_IM-2465-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
940,979_IM-2466-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . hyperexpanded lungs without focal consolidation , pneumothorax or large pleural effusion . right chest wall surgical clips , compatible with prior lumpectomy . negative for acute bone abnormality . "
941,980_IM-2468-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
942,981_IM-2469-1001.dcm.png,unknown
943,982_IM-2470-1001.dcm.png,lungs are clear . no focal airspace consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . there are postoperative changes of cervical spine fusion . 
944,983_IM-2471-1001.dcm.png,normal heart size and mediastinal contours . there are reticular opacities in the medial right middle lobe with tubular airway ectasia which obscures the right heart xxxx . this was present previously and is most compatible with bronchiectasis . there is no focal airspace disease . no pneumothorax or pleural effusion . unremarkable xxxx . 
945,984_IM-2471-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . there are low lung volumes with bronchovascular crowding and scattered opacities in the bilateral lung bases . no focal areas of pulmonary consolidation . no pneumothorax . no large pleural effusion . no acute , displaced rib fractures identified . "
946,985_IM-2472-1001.dcm.png,unknown
947,986_IM-2473-2002.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are normal . 
948,987_IM-2474-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
949,988_IM-2474-1001.dcm.png,lungs are clear . no focal infiltrate . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . 
950,989_IM-2475-1002001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . prior cholecystectomy
951,990_IM-2476-1001.dcm.png,heart size within normal limits . no focal airspace consolidations . no pneumothorax or effusions . 
952,991_IM-2476-1001.dcm.png,the heart size is upper limits of normal . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is mild streaky perihilar opacity without confluent airspace opacity to suggest a bacterial pneumonia . 
953,992_IM-2477-0001-0002.dcm.png,"there are bilateral pulmonary nodules whose appearances suggest metastatic disease to lungs . in the right lung , there is a 1 . 9 x 2 . 1 cm nodule overlying the posterior right 6th rib . there is a 1 . 0 x 1 . 2 cm nodule above this in the interspace between the posterior 5th and 6th ribs on the right . there is a 1 . 0 x 1 . 1 cm nodule projecting through the left 9th and 10th interspaces on the pa view . if not already performed , contrast-enhanced would be suited to evaluate these findings . there are no focal airspace opacities to suggest pneumonia . to the stomach contours appear grossly clear . heart size and pulmonary appear normal . there are left-sided axillary clips . there is a right internal jugular central catheter , the distal tip in right atrium . "
954,993_IM-2478-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
955,995_IM-2478-1001.dcm.png,sternotomy sutures and bypass grafts have been placed in the interval . both lungs remain clear and expanded with no infiltrates . pulmonary are normal . 
956,996_IM-2479-1001.dcm.png,unknown
957,997_IM-2479-1001.dcm.png,calcified mediastinal xxxx . no focal areas of consolidation . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . degenerative changes thoracic spine . 
958,998_IM-2479-1001.dcm.png,"cardiomediastinal silhouette demonstrates normal heart size with tortuosity and atherosclerosis of the thoracic aorta . no focal consolidation , pneumothorax , or pleural effusion . no acute bony abnormality identified . multilevel degenerative disc disease of the thoracic spine noted . "
959,999_IM-2480-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
960,999_IM-2480-3001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
961,1000_IM-0003-1001.dcm.png,there is increased opacity within the right upper lobe with possible mass and associated area of atelectasis or focal consolidation . the cardiac silhouette is within normal limits . opacity in the left midlung overlying the posterior left 5th rib may represent focal airspace disease . no pleural effusion or pneumothorax . no acute bone abnormality . 
962,1000_IM-0003-3001.dcm.png,there is increased opacity within the right upper lobe with possible mass and associated area of atelectasis or focal consolidation . the cardiac silhouette is within normal limits . opacity in the left midlung overlying the posterior left 5th rib may represent focal airspace disease . no pleural effusion or pneumothorax . no acute bone abnormality . 
963,1001_IM-0004-1001.dcm.png,interstitial markings are diffusely prominent throughout both lungs . heart size is normal . pulmonary normal . 
964,1002_IM-0004-1001.dcm.png,unknown
965,1003_IM-0005-2002.dcm.png,heart size and pulmonary vascularity appear within normal limits . retrocardiac soft tissue density is present . there appears to be air within this which could suggest that this represents a hiatal hernia . vascular calcification is noted . calcified granuloma is seen . there has been interval development of bandlike opacity in the left lung base . this may represent atelectasis . no pneumothorax or pleural effusion is seen . osteopenia is present in the spine . 
966,1004_IM-0005-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . the aorta is tortuous and ectatic . there are degenerative changes of the acromioclavicular joints . there degenerative changes of the spine . there is an ivc identified . "
967,1005_IM-0006-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
968,1006_IM-0007-1001.dcm.png,the lungs appear clear . there are no focal airspace opacities to suggest pneumonia . the pleural spaces are clear . the heart and pulmonary are normal . mediastinal contours are normal . there is no pneumothorax . 
969,1007_IM-0008-1001.dcm.png,"trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures show no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
970,1007_IM-0008-3001.dcm.png,"trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures show no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
971,1008_IM-0009-4004.dcm.png,heart size and mediastinal contours are normal in appearance . no consolidative airspace opacities . no radiographic evidence of pleural effusion or pneumothorax . visualized osseous structures appear intact . 
972,1009_IM-0010-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
973,1010_IM-0012-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
974,1011_IM-0013-1001.dcm.png,the heart is top normal in size . the mediastinum is unremarkable . the lungs are clear . 
975,1012_IM-0013-1001.dcm.png,lung volumes are low . bibasilar consolidation and bilateral costophrenic blunting are present . heart size normal . pulmonary normal . shunt tubing traverses the entire image from top to xxxx . 
976,1013_IM-0013-1001.dcm.png,"stable mild cardiomegaly . no pneumothorax , pleural effusion , or focal airspace disease . bony structures intact . right humeral head bone anchor . "
977,1014_IM-0013-1001.dcm.png,unknown
978,1015_IM-0001-1001.dcm.png,"streaky and patchy bibasilar opacities , triangular density projected over the heart on the lateral view . no definite pleural effusion seen , no typical findings of pulmonary edema . considering differences in technical factors stable cardiomediastinal silhouette with normal heart size . "
979,1015_IM-0013-1001.dcm.png,"streaky and patchy bibasilar opacities , triangular density projected over the heart on the lateral view . no definite pleural effusion seen , no typical findings of pulmonary edema . considering differences in technical factors stable cardiomediastinal silhouette with normal heart size . "
980,1016_IM-0013-1001.dcm.png,unknown
981,1017_IM-0013-1001.dcm.png,both lungs are clear and expanded with no infiltrates . basilar focal atelectasis is present in the lingula . heart size normal . calcified right hilar are present
982,1018_IM-0014-5001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are small calcified granulomata in the right lateral lung . 
983,1019_IM-0015-1001.dcm.png,the heart size and mediastinal contours appear within normal limits . there is blunting of the right lateral costophrenic sulcus which could be secondary to a small effusion versus scarring . no focal airspace consolidation or pneumothorax . no acute bony abnormalities . 
984,1020_IM-0017-1001.dcm.png,lung volumes are low . no focal infiltrates . heart size normal . 
985,1021_IM-0017-1001-0001.dcm.png,unknown
986,1022_IM-0017-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . no change in the small calcified right upper lobe nodule . heart and mediastinum normal . 
987,1023_IM-0018-1001.dcm.png,the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of a large pleural effusion . there is no evidence of pneumothorax . 
988,1024_IM-0019-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
989,1025_IM-0020-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . calcified granuloma , right base . normal xxxx . "
990,1026_IM-0021-2002.dcm.png,the lungs appear clear . the heart and pulmonary appear normal . the pleural spaces are clear . mediastinal contours are normal . 
991,1027_IM-0021-1001.dcm.png,this examination is somewhat limited secondary to obscuration of the bilateral posterior costophrenic sulci on the lateral view . the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no large pleural effusion . the thoracic spine appears intact . 
992,1028_IM-0022-1001.dcm.png,"cardiac and mediastinal contours are within normal limits . the lungs are clear . acromioclavicular arthritis is present , severe . "
993,1029_IM-0022-1001.dcm.png,unknown
994,1030_IM-0024-1001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . mild degenerative changes of the spine . 
995,1031_IM-0025-4004.dcm.png,unknown
996,1032_IM-0026-1001-0002.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are calcifications projecting of the left midlung , unchanged from prior , this is is sequela of prior granulomatous disease . there are small t-spine osteophytes . "
997,1033_IM-0027-4004.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . lung volumes are low with central bronchovascular crowding and patchy basilar atelectasis . . degenerative changes of the spine . 
998,1034_IM-0028-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . right middle lobe calcified granuloma is unchanged . heart and mediastinum unchanged . no change hiatus hernia . 
999,1035_IM-0028-1001.dcm.png,right xxxx-a-xxxx is in xxxx . the heart size and pulmonary vascularity appear within normal limits . some prominent perihilar opacities are present . some vague small nodular opacities are present in the right upper lung zone . these are slightly more prominent than on the previous study . no pleural effusion or pneumothorax is seen . 
1000,1036_IM-0029-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size . pulmonary vasculature is within normal limits . no focal consolidations , effusions , or pneumothoraces . mild degeneration of the thoracic spine without acute bony abnormality . "
1001,1037_IM-0029-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . a tortuous , calcified thoracic aorta is present . the lungs are hyperexpanded , consistent with emphysema . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
1002,1038_IM-0029-1001.dcm.png,unknown
1003,1039_IM-0030-1002.dcm.png,no pneumothorax or pleural effusion . normal cardiac contour . clear lungs bilaterally . 
1004,1040_IM-0032-4004.dcm.png,unknown
1005,1041_IM-0033-1001.dcm.png,lucency crosses the 10th left posterior rib . visualized portions of the thoracic spine are unremarkable . mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1006,1042_IM-0034-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
1007,1043_IM-0035-0001-0002.dcm.png,"normal cardiomediastinal silhouette . interval improvement in lung volumes bilaterally . improved aeration of the right and left lung bases . bilateral small pleural effusions and left base atelectatic change , with interval improvement . visualized of the chest are within normal limits . "
1008,1044_IM-0036-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . there has been clearing of left base airspace opacities . the lungs now appear clear . no pneumothorax or pleural effusion is seen . the lungs appear hyperexpanded consistent with emphysema . 
1009,1045_IM-0036-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . chronic appearing contour deformity of the right posterolateral 7th rib again noted suggestive of old injury . "
1010,1046_IM-0036-1001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
1011,1047_IM-0036-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1012,1048_IM-0036-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . mild bilateral acromioclavicular joint and thoracic spine degenerative changes are noted . "
1013,1049_IM-0036-1001.dcm.png,unknown
1014,1050_IM-0038-4004.dcm.png,"technically limited study secondary to patient xxxx . decreased lung volumes with associated bronchopulmonary crowding without evidence of focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . "
1015,1051_IM-0039-5001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
1016,1052_IM-0040-1001.dcm.png,"the trachea is midline . cardio mediastinal silhouette is normal in contour with overlying sternotomy xxxx . the lungs are clear without acute infiltrate , effusion or pneumothorax . the visualized bony structures reveal no fractures or dislocations . "
1017,1053_IM-0040-1001.dcm.png,"there are postoperative changes of sternotomy and cabg . there is stable mild cardiomegaly . there are scattered of subsegmental atelectasis , decreased from the prior chest radiograph . no focal airspace consolidation . no pleural effusion or pneumothorax . there are minimal degenerative changes of the spine . "
1018,1054_IM-0040-1001.dcm.png,"heart size is normal . stable mediastinal contour . no focal airspace consolidation , suspicious pulmonary opacity , pneumothorax , or pleural effusion . mild thoracic spine degenerative change . "
1019,1055_IM-0040-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1020,1056_IM-0040-1001.dcm.png,normal heart size . stable tortuous aorta . no pneumothorax or pleural effusion . no suspicious focal air space opacities . levoscoliosis of the thoracolumbar spine . hyperinflated lungs with flattened diaphragms are consistent with emphysematous lung changes . prior granulomatous disease . 
1021,1056_IM-0040-1002.dcm.png,normal heart size . stable tortuous aorta . no pneumothorax or pleural effusion . no suspicious focal air space opacities . levoscoliosis of the thoracolumbar spine . hyperinflated lungs with flattened diaphragms are consistent with emphysematous lung changes . prior granulomatous disease . 
1022,1057_IM-0041-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no discrete nodules or adenopathy identified . 
1023,1058_IM-0041-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . innumerable bilateral lung nodules are present . these are seen diffusely throughout both lungs . no superimposed focal airspace disease is seen . no pleural effusion or pneumothorax is identified . scoliosis is present . 
1024,1059_IM-0041-1001.dcm.png,stable cardiomediastinal silhouette with tortuous aorta . prior granulomatous disease . no pneumothorax or pleural effusion . stable retrocardiac airspace opacity . 
1025,1060_IM-0042-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . mild dextrocurvature the spine . 
1026,1061_IM-0043-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is slight wedge deformity of the mid to lower thoracic vertebral body unchanged from the comparison study . "
1027,1062_IM-0043-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . no displaced rib fracture visualized . 
1028,1063_IM-0044-84654001.dcm.png,"there is minimal opacity in the left lung base , representing atelectasis . the lungs are otherwise clear . heart size is normal . no pneumothorax . "
1029,1064_IM-0045-1001.dcm.png,there is stable elevation of the right hemidiaphragm with questionable increased right basilar airspace opacities . the left lung is clear . heart size normal . unremarkable . 
1030,1065_IM-0046-1001.dcm.png,"there has been interval cabg . sternotomy and cerclage appear intact . no focal air space opacity . no pleural effusion or pneumothorax . stable , mild degenerative disc disease of the thoracic spine . visualized bony structures are otherwise unremarkable in appearance . atherosclerotic calcifications of the thoracic aorta . "
1031,1066_IM-0047-1001.dcm.png,unknown
1032,1067_IM-0048-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . no suspicious pulmonary nodules or masses . bony thorax and soft tissues grossly unremarkable . "
1033,1069_IM-0049-1001.dcm.png,"heart size within normal limits . there is mild hyperexpansion with flattening diaphragms and bronchovascular crowding in the lung bases compatible with emphysema . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
1034,1070_IM-0050-1001.dcm.png,"there is abnormal separation of the right xxxx . this is age-indeterminate . corticated bony density over the lateral aspect of the clavicle may reflect sequela of old remote xxxx . the cardia mediastinal silhouette , pulmonary vascular pattern are normal . no pneumothorax . no pleural effusion . no pulmonary edema . there is minimal endplate degenerative changes of the midthoracic spine . partial obscuration retrosternal space due to overlying xxxx . "
1035,1072_IM-0052-1001-0002.dcm.png,"the heart and mediastinal contours are stable . aorta is calcified and tortuous , compatible with atherosclerotic disease . since the prior study , there's been interval development of left lower lobe airspace disease . the right lung is clear . "
1036,1073_IM-0053-1001.dcm.png,"the lungs are hyperexpanded , with flattened diaphragms . the cardiomediastinal silhouette is normal in size and stable from prior exam . there is mild tortuosity of the thoracic aorta . there is no pneumothorax or large pleural effusion . there are degenerative changes of the thoracic spine . "
1037,1074_IM-0054-1001.dcm.png,the cardiomediastinal silhouette is stable . lung volumes remain low . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
1038,1075_IM-0054-1001.dcm.png,"lungs are hyperinflated with interstitial changes of severe emphysema . there is an ill-defined pleural parenchymal opacity in the left upper lobe . this may represent scarring but is incompletely evaluated on the outside study , without coronal and sagittal reformats . there is mild scarring and/or atelectasis in the lung bases . lungs otherwise grossly clear . there is no pneumothorax or pleural effusion . heart size is normal . there are mild degenerative endplate changes in the thoracic spine . there is generalized osteopenia . "
1039,1076_IM-0054-1001.dcm.png,there is opacity at posterior aspect of lower chest seen on lateral view which probably represents left lower lobe consolidation . there may also be small bilateral pleural effusion . upper limits of normal heart size . mild central vascular prominence . old fracture deformities of multiple right ribs . 
1040,1077_IM-0054-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1041,1078_IM-0055-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
1042,1079_IM-0056-1001.dcm.png,there are low lung volumes . the heart size and upper mediastinum have a normal appearance . there is no pulmonary vascular congestion . there is minimal right basilar atelectasis . there is no large effusion or pneumothorax . the osseous structures appear intact . 
1043,1081_IM-0057-2002.dcm.png,the lungs are hyperexpanded . heart size normal . no mass or focal opacities seen . stable degenerative changes of the thoracic spine . 
1044,1082_IM-0058-1001.dcm.png,"stable cardiomegaly . stable tortuosity of the aorta . no focal airspace opacities , pneumothorax or pleural effusion . mild degenerative changes of the thoracic spine . "
1045,1083_IM-0058-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . no pleural effusion . there are gastroesophageal junction and epigastric postsurgical changes . "
1046,1084_IM-0058-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
1047,1085_IM-0059-1001.dcm.png,"the lungs demonstrate low lung volumes but are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . mild streaky opacities in the left upper lobe on frontal projection are atelectatic or scar . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1048,1086_IM-0059-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there is corticated irregularity of the right posterior 5th rib , secondary to old rib fracture . there are no gross acute bony findings . "
1049,1087_IM-0060-1002001.dcm.png,there is a calcified granuloma in the left upper lobe . lungs otherwise are believed to be clear . the heart is normal . there are calcified left hilar and mediastinal lymph xxxx . the skeletal structures show some senescent changes . 
1050,1088_IM-0061-1001.dcm.png,"heart is within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . mild streaky opacity lateral right lung , atelectasis versus scarring . "
1051,1089_IM-0061-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the descending thoracic aorta is tortuous . central venous catheter is again noted . the lungs are free of focal airspace disease . the left hemidiaphragm remains elevated . no pneumothorax or pleural effusion is seen . 
1052,1090_IM-0062-1001.dcm.png,unknown
1053,1091_IM-0062-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1054,1092_IM-0063-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . "
1055,1093_IM-0064-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1056,1094_IM-0065-1001.dcm.png,"no acute osseous abnormality . the soft tissues are within normal limits . normal appearing cardiomediastinal silhouette and hilar contours . left lower lobe density representing atelectasis . no focal area of consolidation , pleural effusion , pneumothorax . "
1057,1095_IM-0066-1001.dcm.png,"the lungs appear clear . the heart and pulmonary appear normal . there is severe kyphotic deformity of the chest involving prior fractures of thoracic vertebral bodies and the sternum . there are multiple fractures identified involving upper thoracic vertebral bodies and a single upper lumbar vertebral body . the patient is status post vertebroplasty at multiple levels . the pleural spaces appear clear . there is right-sided chest xxxx , the distal tip in the upper right atrium . mediastinal contours appear normal . "
1058,1097_IM-0067-1001.dcm.png,"heart size and mediastinal contours are within normal limits . diffuse bilateral calcified sequelae of prior granulomatous infection . no pulmonary vascular congestion . no edema . no focal consolidation . there is no visible pleural effusion or pneumothorax . there is mild anterior wedging of a lower thoracic vertebral body , approximately t11 level . "
1059,1098_IM-0067-1001.dcm.png,the lungs are hyperinflated with coarse interstitial markings compatible with obstructive pulmonary disease and emphysema . there is chronic pleural-parenchymal scarring within the lung bases . no lobar consolidation is seen . no pleural effusion or pneumothorax . heart size is normal . 
1060,1099_IM-0067-1001.dcm.png,"there are changes of sternotomy and cabg . heart size is within normal limits . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
1061,1100_IM-0068-1001.dcm.png,heart is large . pulmonary are engorged . bibasilar interstitial infiltrates and bilateral costophrenic blunting are present . 
1062,1101_IM-0068-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are degenerative changes of the spine . "
1063,1101_IM-0068-3001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are degenerative changes of the spine . "
1064,1102_IM-0069-12012.dcm.png,"there is stable cardiomegaly with pulmonary vascular congestion and probable mild interstitial edema . there are bilateral pleural effusions with bibasilar airspace disease , right greater than left . there is no pneumothorax . there are no acute bony findings . "
1065,1102_IM-0069-4004.dcm.png,"there is stable cardiomegaly with pulmonary vascular congestion and probable mild interstitial edema . there are bilateral pleural effusions with bibasilar airspace disease , right greater than left . there is no pneumothorax . there are no acute bony findings . "
1066,1103_IM-0070-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . there is a stable calcified granuloma in the infrahilar right lung . there are mild degenerative changes along the thoracic spine . no acute bony abnormality is identified . 
1067,1104_IM-0071-1001.dcm.png,unknown
1068,1105_IM-0072-1001-0001.dcm.png,"mild cardiomegaly . mediastinal normal width . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . scarring or atelectasis right midlung . "
1069,1106_IM-0073-1001.dcm.png,unknown
1070,1107_IM-0074-1001.dcm.png,unknown
1071,1108_IM-0075-1001.dcm.png,the lungs are clear and hyperinflated . heart size is normal . no pneumothorax . 
1072,1109_IM-0076-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1073,1110_IM-0076-1001.dcm.png,"cardiomediastinal contours within normal limits . pulmonary vascularity is normal . there are scattered calcified testes bilaterally , consistent with prior granulomatous infection , stable . no focal airspace consolidation . no pleural effusion , no pneumothorax . bony structures unremarkable . "
1074,1111_IM-0077-4004.dcm.png,lordotic projection and large body habitus . limited mediastinal evaluation . severe cardiomegaly . no visualized pneumothorax . no large effusion or airspace disease . no fracture . 
1075,1112_IM-0078-1001.dcm.png,there is widening of the mediastinum . there is moderate cardiomegaly identified . the central pulmonary appear enlarged . correlate for pulmonary vascular congestion . no focal infiltrate . no large effusion or pneumothorax . 
1076,1113_IM-0078-1001.dcm.png,"previous sulcal is normal in size and contour . lungs are clear . no focal consolidation , pneumothorax , or pleural effusion . interval resolution of previously described right midlung opacity suggesting resolved inflammatory/infectious process . lungs are hyperexpanded with flattened diaphragms . and soft tissue are unremarkable . "
1077,1114_IM-0079-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1078,1115_IM-0079-1001.dcm.png,normal heart size and mediastinal contours . no abnormal airspace opacities . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable appearance . 
1079,1116_IM-0079-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . and curvilinear densities over the breast shadows compatible with piercings . "
1080,1117_IM-0079-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is ill-defined airspace opacity in the posterior left lower lobe . there is focal opacity in the right upper lobe which suggests scar and/or granulomatous calcification . there is no pneumothorax or pleural effusion . 
1081,1118_IM-0079-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
1082,1119_IM-0080-1001.dcm.png,low lung volumes with bronchovascular crowding . sequela of prior granulomatous disease . otherwise lungs clear . heart size normal . stable severe l1 deformity . 
1083,1120_IM-0080-1001.dcm.png,normal heart size and mediastinal contours . low lung volumes with no significant airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . 
1084,1121_IM-0080-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures show several old rib fractures unchanged in the prior study on the left . 
1085,1122_IM-0080-1001-0001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
1086,1122_IM-0080-1001-0002.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
1087,1123_IM-0080-1001.dcm.png,"opacities projecting over the right apex and mediastinum on pa view are artifactual . stable cardiomediastinal silhouette . pulmonary vascularity is unremarkable . stable chronic coarse interstitial markings , without focal airspace disease or consolidation . negative for pneumothorax or pleural effusion . limited evaluation reveals the are grossly intact . right cervical rib . "
1088,1124_IM-0081-2001.dcm.png,there are postoperative changes of sternotomy . heart size is within normal limits . there is aortic atherosclerotic vascular calcification . the lungs are mildly hyperexpanded . there is no focal airspace consolidation . no pleural effusion or pneumothorax . there are diffuse degenerative changes of the spine . 
1089,1125_IM-0082-2001.dcm.png,"borderline enlarged heart . stable mediastinal contours . aortic calcifications . hyperinflated lungs with chronic appearing interstitial markings , compatible with emphysema . bilateral streaky opacities . increased vascularity compatible with pulmonary vascular congestion . no focal airspace disease . no acute bony abnormality . "
1090,1126_IM-0082-1001.dcm.png,sternotomy and mediastinal surgical clips remain in xxxx . the cardiomediastinal silhouette is stable in appearance . the thoracic aorta is tortuous and calcified with stable appearance since exam . no focal areas of pulmonary consolidation . scattered right basilar subsegmental atelectasis . the left lung appears clear . no pneumothorax or pleural effusion present . moderate degenerative changes of the thoracic spine . osteopenia . mild loss of of a mid thoracic vertebral body . 
1091,1128_IM-0084-5001.dcm.png,unknown
1092,1129_IM-0085-1001.dcm.png,"there is mild cardiomegaly . pulmonary vasculature is normal in caliber . there are mild opacities bilaterally , favoring scar or atelectasis . the lungs are otherwise clear . there is no pneumothorax or pleural effusion . no acute , displaced rib fractures are demonstrated . visualized vertebral body are grossly intact . "
1093,1130_IM-0087-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . calcified granuloma is present in the right base . no pneumothorax or pleural effusion is seen . in the lateral right base is identified an ill-defined somewhat oblong opacity . this was not present on the previous study . the remainder of the lungs appear clear . 
1094,1131_IM-0088-0001-0002.dcm.png,"2 images . calcified granuloma , right lung base . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1095,1133_IM-0090-1001.dcm.png,lungs are hyperexpanded . no infiltrates or masses . the eventration of the left hemidiaphragm identified previously is largely unchanged since the previous computed tomogram . pulmonary are normal . 
1096,1134_IM-0091-1001.dcm.png,there is a left chest with tip in the mid svc . the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
1097,1135_IM-0091-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . stable small calcified granuloma left base . no acute findings/opacities/infiltrates noted . "
1098,1136_IM-0092-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
1099,1137_IM-0093-12012.dcm.png,unknown
1100,1137_IM-0093-4004.dcm.png,unknown
1101,1138_IM-0094-1001.dcm.png,no pleural effusions . no pneumothorax . no focal areas of consolidation . heart size within normal limits . osseous structures intact . 
1102,1139_IM-0095-1001.dcm.png,cardiomegaly . mediastinal contours are normal limits . increased interstitial opacities . no pneumothorax or large pleural effusion . no acute osseous abnormality . 
1103,1140_IM-0096-1001.dcm.png,unknown
1104,1141_IM-0096-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1105,1142_IM-0096-1001.dcm.png,unknown
1106,1143_IM-0096-1001.dcm.png,unknown
1107,1144_IM-0097-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1108,1145_IM-0097-2002.dcm.png,lungs are hyperexpanded . there is no focal airspace consolidation . no suspicious pulmonary mass or nodule is seen . no pleural effusion or pneumothorax . normal heart size and mediastinal contour . 
1109,1146_IM-0098-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . calcified lingular pulmonary granuloma . normal pulmonary vascularity . 
1110,1147_IM-0099-4004.dcm.png,unknown
1111,1148_IM-0100-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1112,1149_IM-0101-1001.dcm.png,"several calcified granulomas in bilateral hilar regions . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . "
1113,1150_IM-0102-1003.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1114,1151_IM-0102-1001.dcm.png,"frontal and lateral views of the chest demonstrate the cardiomediastinal silhouette normal . there is normal distribution of the pulmonary vascularity . the lungs are clear . no effusion , consolidation , or pneumothorax . "
1115,1152_IM-0103-1001.dcm.png,"the heart is enlarged . the mediastinum is unremarkable . atherosclerotic calcifications present within the thoracic aorta . there is no pleural effusion , pneumothorax , or focal airspace disease . chronic degenerative changes are noted within the spine . "
1116,1153_IM-0104-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . are intact . "
1117,1154_IM-0104-1001.dcm.png,normal heart size . clear lungs . degenerative this disease within the spine . prosthetic right shoulder . possible body in the axillary recess of the left shoulder . degenerative left glenohumeral osteoarthritis . 
1118,1156_IM-0106-1001.dcm.png,unknown
1119,1157_IM-0106-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is a region of left upper lobe perihilar opacity identified . "
1120,1158_IM-0107-1001.dcm.png,heart size remains slightly large . aorta remains tortuous . pulmonary remain normal . no infiltrates or masses in the lungs . 
1121,1159_IM-0107-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
1122,1160_IM-0107-1001.dcm.png,"the left hilum is retracted superiorly . in the collapsed left upper lobe are stranding and pneumatoceles . additionally , pleural thickening is present in the left apex . no infiltrates are present in the left lower lobe or in the right lung . heart size is normal . these findings are similar to the previous outside examination . "
1123,1161_IM-0107-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1124,1162_IM-0108-1001.dcm.png,unknown
1125,1163_IM-0108-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . heart size upper limit of normal . visualized osseous structures of the thorax are without acute abnormality . "
1126,1164_IM-0109-0001-0002.dcm.png,unknown
1127,1165_IM-0110-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
1128,1166_IM-0111-1001.dcm.png,low lung volumes . cardiomediastinal silhouette and pulmonary vasculature are within normal limits . streaky bibasilar airspace opacities . no pneumothorax or pleural effusion . no acute osseous findings . 
1129,1167_IM-0112-1001.dcm.png,"the lungs are hyperexpanded . there are opacities in the lingula , subsegmental atelectasis or scarring . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size is within normal limits . there is aortic atherosclerotic vascular calcification . there are degenerative changes of the spine . "
1130,1168_IM-0112-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1131,1169_IM-0113-0001-0002.dcm.png,"lung volumes are low . there is vague opacity in the right upper lung near the anterior right first rib on pa view . this may be artifact relating to calcification at the first rib costicartilage junction . there is minimal atelectasis in the right lung base . there is left-sided picc line , the distal tip in the lower superior vena xxxx . the heart and pulmonary are normal . these contours are normal . "
1132,1170_IM-0115-2001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . mild cardiomegaly . cardio mediastinal silhouette unremarkable . bony structures appear intact . "
1133,1171_IM-0116-1001.dcm.png,heart size upper limits of normal . low lung volumes with mild bronchovascular crowding and right basilar airspace disease . no pneumothorax or effusions . 
1134,1172_IM-0117-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1135,1173_IM-0118-5001.dcm.png,"pa and moderate loss of the chest demonstrate stable moderate cardiomediastinal silhouette with atherosclerotic calcifications of the aortic and mild aortic ectasia . emphysematous changes with flattening of the hemidiaphragms . blunting of the costophrenic xxxx , and secondary to scarring/emphysematous changes . no evidence of focal airspace consolidation large pleural effusion or pneumothorax . visualized osseous structures appear intact . "
1136,1174_IM-0118-1001.dcm.png,"normal cardiac contours . no pneumothorax or pleural effusions . clear left lung xxxx . right middle lobe with increased opacities , representative of infiltrate . "
1137,1175_IM-0119-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1138,1176_IM-0119-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . . 
1139,1177_IM-0120-1001.dcm.png,normal heart . clear lungs . trachea midline . scoliosis of lower thoracic spine . degenerative changes of thoracic spine . 
1140,1178_IM-0121-1001.dcm.png,trachea is midline . normal heart . clear lungs . no pneumothorax . no pleural effusion . 
1141,1179_IM-0122-2002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . a few bandlike opacities are present on the lateral view which appear to represent small areas of scarring . surgical clips are present in the right upper quadrant of the abdomen . degenerative changes are present in the spine . 
1142,1180_IM-0123-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . there is mild tortuosity to the descending thoracic aorta . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no discrete nodules or adenopathy are noted . degenerative changes are present in the spine . 
1143,1182_IM-0124-1001.dcm.png,"heart size within normal limits . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . "
1144,1183_IM-0124-1001.dcm.png,unknown
1145,1184_IM-0124-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . low lung volumes on the ap view with bronchovascular crowding and bibasilar atelectasis . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
1146,1187_IM-0126-1001.dcm.png,"minimally increased airspace opacities bilaterally , most prominent in the lung bases . heart size is within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . "
1147,1188_IM-0127-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1148,1189_IM-0128-1001.dcm.png,"normal heart size and hilar vascular markings . evidence of prior granulomatous disease . the lungs are clear without focal area of consolidation , pleural effusion , or pneumothorax . there are no acute osseous abnormalities present . mild degenerative changes of the thoracic spine . the soft tissues are within normal limits . "
1149,1190_IM-0128-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1150,1190_IM-0128-1002.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1151,1191_IM-0128-1001.dcm.png,"heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no acute bony changes . "
1152,1192_IM-0129-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1153,1193_IM-0129-1001.dcm.png,"stable enlarged cardiac silhouette . persistent bilateral lower lobe airspace disease , not significantly compared to prior . no pleural effusion or pneumothorax . no acute bony abnormality . "
1154,1195_IM-0131-1001.dcm.png,"coronary artery stents visualized . the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
1155,1196_IM-0131-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the aorta is atherosclerotic . airspace disease within the left lower lung . the remainder of the lungs are clear . there is no pleural effusion or pneumothorax . surgical clips overlying the right breast . 
1156,1197_IM-0131-1001.dcm.png,"and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . bilateral prominent lung vascularity medially , unchanged . "
1157,1198_IM-0132-1001.dcm.png,unknown
1158,1199_IM-0133-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . the lungs are well expanded without consolidation or edema . no pneumothorax or pleural effusion . visualized osseous structures are unremarkable . 
1159,1200_IM-0134-1001.dcm.png,the heart is not enlarged . the central pulmonary vasculature is not engorged . visualized osseous structures are unremarkable . no pneumothorax or pleural effusion . small right juxtahilar opacity may represent infiltrate . lungs are otherwise well aerated . 
1160,1202_IM-0136-1001.dcm.png,"the heart is large , and the pulmonary are engorged . no infiltrates . "
1161,1203_IM-0137-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there is patchy opacity in the left upper lobe . possibility of tuberculosis should be excluded . no pleural effusion is seen . there is no pneumothorax the lungs are hyperinflated . 
1162,1204_IM-0138-1001.dcm.png,"pa and lateral views the chest were obtained . heart size is upper limits normal or mildly enlarged . the thoracic aorta is mildly tortuous . pulmonary are within normal limits . no pneumothorax , pleural effusion , or focal air space consolidation . "
1163,1205_IM-0138-1001.dcm.png,normal heart size . clear lungs without pneumothorax or pleural effusion . 
1164,1206_IM-0139-1001.dcm.png,unknown
1165,1207_IM-0140-0001-0002.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . there is no pneumothorax . 
1166,1208_IM-0141-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal air space opacity , pleural effusion , or pneumothorax . the osseous structures are intact with mild degenerative changes in thoracic spine . "
1167,1208_IM-0141-3001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal air space opacity , pleural effusion , or pneumothorax . the osseous structures are intact with mild degenerative changes in thoracic spine . "
1168,1209_IM-0142-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1169,1210_IM-0142-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there mild degenerative changes of the thoracic spine . there is a slight deformity of the lower thoracic body which is age-indeterminate . "
1170,1211_IM-0142-1001.dcm.png,normal heart size mediastinal contours . no focal airspace opacity . no pneumothorax or pleural effusion . visualized are unremarkable in appearance . 
1171,1212_IM-0143-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1172,1213_IM-0144-1001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show normal size and configuration of the cardiac silhouette . normal pulmonary vasculature and central airways . no focal airspace consolidation or pleural effusion . 
1173,1214_IM-0144-1001.dcm.png,the heart is normal in size and contour . there is a focal area of scarring or atelectasis identified in the lingula . the lungs are otherwise clear without focal infiltrate . there is no pneumothorax or effusion . 
1174,1217_IM-0145-0001-0002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated with blunted costophrenic xxxx . no focal consolidation is seen . 
1175,1218_IM-0146-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . no acute bony or soft tissue abnormality . "
1176,1219_IM-0146-1001.dcm.png,heart size and mediastinal contours are normal in appearance . no consolidative airspace opacities . no radiographic evidence of pleural effusion or pneumothorax . visualized osseous structures appear intact . 
1177,1220_IM-0148-1001.dcm.png,"there is hyperexpansion , hyperlucency of both lungs , as well as flattening of the diaphragm consistent with chronic emphysematous lung disease . no focal consolidation , pneumothorax , or large pleural effusion identified ( blunting of costophrenic recesses bilaterally may represent small effusions or pleural thickening/scar . stable calcified mediastinal and hilar lymph and a left basilar calcified granuloma . acute osseous abnormality . the mediastinal silhouette stable . "
1178,1220_IM-0148-3001.dcm.png,"there is hyperexpansion , hyperlucency of both lungs , as well as flattening of the diaphragm consistent with chronic emphysematous lung disease . no focal consolidation , pneumothorax , or large pleural effusion identified ( blunting of costophrenic recesses bilaterally may represent small effusions or pleural thickening/scar . stable calcified mediastinal and hilar lymph and a left basilar calcified granuloma . acute osseous abnormality . the mediastinal silhouette stable . "
1179,1221_IM-0149-0001-0002.dcm.png,"no airspace disease , effusion or noncalcified nodule . normal heart size and mediastinum . visualized of the chest are within normal limits . "
1180,1222_IM-0150-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1181,1223_IM-0150-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . foreign body is noted in the soft tissues of the left chest wall . 
1182,1224_IM-0150-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1183,1225_IM-0150-1001.dcm.png,heart size is normal . there is mild tortuosity of the thoracic aorta . no consolidating airspace disease is seen . no pleural effusion or pneumothorax . 
1184,1226_IM-0150-1001.dcm.png,the heart size is within normal limits . trachea is midline . no pleural effusions or pneumothorax . cardiomediastinal contours are normal . there is focal consolidation in the posterior segment of the right lower lobe . no bony or soft tissue abnormalities . 
1185,1228_IM-0151-1001.dcm.png,unknown
1186,1229_IM-0152-1001.dcm.png,there is hyperinflation of the lungs appear to be clear . there is no pleural effusion or the heart is normal . there are atherosclerotic changes of the aorta . the skeletal structures are normal . 
1187,1230_IM-0154-1001.dcm.png,unknown
1188,1230_IM-0154-2001.dcm.png,unknown
1189,1231_IM-0155-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . left subclavian central catheter tip in distal svc . no pneumothorax . the lungs are clear . 
1190,1233_IM-0157-1001.dcm.png,"enlarged cardiomediastinal silhouette . low lung volumes . relative elevation of right hemidiaphragm . left base density . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
1191,1234_IM-0157-4004.dcm.png,2 images . the cardiac silhouette is enlarged . thoracic aortic atherosclerotic calcifications are present . there are finding status post sternotomy and cabg . atelectasis or scar is noted within the left midlung . there is blunting of the left costophrenic xxxx . no pneumothorax . 
1192,1235_IM-0158-1001.dcm.png,lung volumes are xxxx . opacities are present in the angulate . no focal infiltrates . heart size normal . 
1193,1236_IM-0158-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1194,1237_IM-0159-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . there is is a calcified opacity in the left lung base suggestive of old empyema , hematoma , or prior tb . no cavitary lesions are seen . are grossly unremarkable . "
1195,1238_IM-0160-2002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1196,1239_IM-0160-1001.dcm.png,unknown
1197,1240_IM-0162-4001.dcm.png,feeding tube passes below the left hemidiaphragm . left subclavian central line tip is at the upper svc . shunt tubing courses along the anterior left hemithorax . there is grossly stable left lower lobe consolidation . stable mild residual medial right basilar airspace disease . there is no pneumothorax . heart size is within normal limits . there is aortic atherosclerotic vascular calcification . there are diffuse degenerative changes of the spine . 
1198,1241_IM-0163-2002.dcm.png,"the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there is a scoliosis of the thoracic spine . the ribs , as visualized , appear unremarkable . "
1199,1242_IM-0164-1001.dcm.png,the heart is normal in size . the mediastinum is stable with tortuous aorta . there are chronic changes particularly noted in the lung apices . the are mildly prominent but stable . no acute infiltrate is seen . there is no pleural effusion . 
1200,1243_IM-0165-4004.dcm.png,"cardiac silhouette is enlarged but unchanged . there is left-sided central line with a lumen . poly vasculature is within normal limits . mediastinum is normal . bibasilar opacity , left greater than right is appreciated . no pneumothorax . "
1201,1244_IM-0166-2001.dcm.png,"redemonstration of colonic interposition overlying the mediastinum . there are increased bibasilar airspace opacities , left greater than right . no pneumothorax or large pleural effusion . "
1202,1245_IM-0167-1001.dcm.png,unknown
1203,1246_IM-0167-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are otherwise clear . thoracic spondylosis . bilateral breast prostheses with calcification . 
1204,1248_IM-0168-1001.dcm.png,heart size is normal . no focal consolidations . there are degenerative changes throughout the midlower thoracic spine . no pneumothorax or pleural effusion . 
1205,1249_IM-0169-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there are calcified granulomas in the left lower lobe . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
1206,1250_IM-0169-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . large bilateral hilar calcified lymph xxxx/granulomas . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1207,1252_IM-0170-1001.dcm.png,unknown
1208,1253_IM-0171-0001-0002.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1209,1254_IM-0172-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1210,1255_IM-0172-1001-0001.dcm.png,right-sided chest tube tip now projects outside the thoracic cavity . no definite residual pneumothorax . stable cardiomediastinal silhouette . there are low lung volumes . no large pleural effusion . no focal airspace consolidation . small amount of subdiaphragmatic free air . 
1211,1256_IM-0173-1001.dcm.png,"the heart is normal in size and contour . there is mild calcification of the transverse xxxx . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . degenerative changes of the midthoracic spine are noted . "
1212,1257_IM-0174-1001.dcm.png,"mild cardiomegaly . hypoinflation of the lungs . right basilar opacity may represent atelectasis . lungs are otherwise clear without focal consolidation , pleural effusion , or pneumothorax . sclerosis of the humeral bilateral , from prior avn . sclerotic vertebral body endplates with central depression . calcifications in the right hemiabdomen may represent calcified gallstones . "
1213,1258_IM-0175-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1214,1259_IM-0175-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1215,1260_IM-0176-1001.dcm.png,unknown
1216,1261_IM-0177-1001.dcm.png,"mild cardiomegaly . normal pulmonary vascularity . tortuosity of the descending aorta . no focal infiltrate , pneumothorax or pleural effusion . "
1217,1262_IM-0178-0001.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . there are low lung volumes . there is no focal consolidation . there is pneumothorax . there is no large pleural effusion . there is prominent right anterior first rib end . 
1218,1263_IM-0179-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1219,1264_IM-0179-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1220,1265_IM-0179-1001.dcm.png,"normal heart size . there is a round density in the ap xxxx . study performed in is not available for review at this time . lungs are hyperinflated with flattened diaphragms . calcified right lower lobe granuloma . no focal airspace consolidation , pneumothorax , or pleural effusion . no pulmonary edema . no acute bony abnormality . "
1221,1266_IM-0179-1001.dcm.png,the lungs are clear . there are calcified granulomas . heart size is normal . no pneumothorax . 
1222,1267_IM-0179-1001.dcm.png,no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . 
1223,1269_IM-0181-1001.dcm.png,"normal heart size . hyperexpanded lungs without focal consolidation , pneumothorax or large pleural effusion . left nipple silhouette visualized . negative for acute bone abnormality . "
1224,1270_IM-0181-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1225,1271_IM-0182-4004.dcm.png,"the heart is within normal limits in size given the low lung volumes an ap portable technique . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1226,1272_IM-0183-1001.dcm.png,there are scattered calcified granulomas . the lungs are otherwise clear . no focal airspace consolidation . no pleural effusion or pneumothorax . normal heart size and mediastinal contour . right humeral internal fixation is noted . 
1227,1273_IM-0183-1001.dcm.png,heart is mildly enlarged stable . mediastinal contour is normal . pulmonary vascularity is normal . lungs are hyperexpanded but clear . no pleural effusions or pneumothoraces . 
1228,1274_IM-0183-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
1229,1276_IM-0184-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . calcific granulomas are present in the right upper lobe . the are unremarkable . "
1230,1276_IM-0184-3001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . calcific granulomas are present in the right upper lobe . the are unremarkable . "
1231,1277_IM-0185-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . no pneumothorax , pleural effusion , or lobar air space consolidation . right middle lobe collapse appears less distinct than on prior study . "
1232,1278_IM-0185-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1233,1279_IM-0185-1001.dcm.png,there is no focal consolidation . there is no pneumothorax or large pleural effusion . the cardiomediastinal contours are grossly unremarkable . the heart size is within normal limits . the right upper extremity picc tip is in the upper svc . surgical clips in the right upper abdomen . 
1234,1280_IM-0187-1001.dcm.png,the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of pleural effusion . there is no evidence of pneumothorax . 
1235,1282_IM-0188-1001.dcm.png,normal heart size and mediastinal contours . patchy right lower lobe airspace opacities . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . 
1236,1283_IM-0188-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are calcified granulomas noted . there are vascular calcifications over the aortic xxxx . "
1237,1285_IM-0188-0001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . mild nodular prominence of the right hilum , without significant change . lung volumes are decreased , with crowding . there is no pneumothorax , pleural effusion , or focal air space consolidation . "
1238,1287_IM-0188-1001.dcm.png,sequelae of old granulomatous disease . no suspicious pulmonary nodules or masses . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the thoracic spine . 
1239,1288_IM-0189-1001.dcm.png,pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . prominent bilateral pericardial fat pads . the lungs are well aerated . there is minimal patchy and air space opacity within the lingula favored as atelectasis . 
1240,1289_IM-0189-1001.dcm.png,one are low . both costophrenic are blunted . pulmonary are normal . no visible infiltrates in the aerated lungs . 
1241,1290_IM-0189-1001.dcm.png,"there is a 22 x 14 mm calcified nodule in the left lower lobe . a moderate hiatal hernia is present . cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . "
1242,1291_IM-0190-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . mild prominence left hilar contour . bony structures are intact . 
1243,1292_IM-0191-1001.dcm.png,"borderline enlarged heart . torturous/ectatic thoracic aorta . no focal pulmonary opacity , pleural effusion or pneumothorax . there are degenerative changes of the spine . there is fracture of distal right clavicle , better seen on the right shoulder radiographs dated xxxx . small round lucency in the distal left clavicle , appears benign . degenerative changes of both joints . "
1244,1293_IM-0192-4004.dcm.png,unknown
1245,1294_IM-0193-1001.dcm.png,lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures and soft tissues are normal . 
1246,1295_IM-0194-3003.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . mild degenerative changes are present in the spine . 
1247,1296_IM-0195-1001-0002.dcm.png,unknown
1248,1297_IM-0195-4004.dcm.png,unknown
1249,1301_IM-0198-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours , mediastinal calcifications suggest a previous granulomatous process . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
1250,1302_IM-0198-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum are stable with ectasia of the aorta . heart size is upper limits of normal . degenerative changes in the spine . 
1251,1303_IM-0199-1001-0001.dcm.png,"in the interval , a 3 cm uncalcified mass has developed in the posterior segment of the right upper lobe . in addition , on the pa view , an 8 mm opacity is adjacent to the left of the heart . this opacity cannot be well identified on the lateral view . it may be artifactual , but another mass on the left cannot be excluded . mediastinum is normal with no evidence for adenopathy . heart size normal . note of an unchanged hiatal hernia . "
1252,1303_IM-0199-1001-0002.dcm.png,"in the interval , a 3 cm uncalcified mass has developed in the posterior segment of the right upper lobe . in addition , on the pa view , an 8 mm opacity is adjacent to the left of the heart . this opacity cannot be well identified on the lateral view . it may be artifactual , but another mass on the left cannot be excluded . mediastinum is normal with no evidence for adenopathy . heart size normal . note of an unchanged hiatal hernia . "
1253,1303_IM-0199-2001-0001.dcm.png,"in the interval , a 3 cm uncalcified mass has developed in the posterior segment of the right upper lobe . in addition , on the pa view , an 8 mm opacity is adjacent to the left of the heart . this opacity cannot be well identified on the lateral view . it may be artifactual , but another mass on the left cannot be excluded . mediastinum is normal with no evidence for adenopathy . heart size normal . note of an unchanged hiatal hernia . "
1254,1303_IM-0199-2001-0003.dcm.png,"in the interval , a 3 cm uncalcified mass has developed in the posterior segment of the right upper lobe . in addition , on the pa view , an 8 mm opacity is adjacent to the left of the heart . this opacity cannot be well identified on the lateral view . it may be artifactual , but another mass on the left cannot be excluded . mediastinum is normal with no evidence for adenopathy . heart size normal . note of an unchanged hiatal hernia . "
1255,1304_IM-0199-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1256,1305_IM-0199-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1257,1306_IM-0200-2001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . there are diminished lung volumes . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . scoliosis is unchanged . visualized upper abdomen is grossly unremarkable . "
1258,1308_IM-0201-1001.dcm.png,normal heart size and mediastinal contours . clear lungs . no pneumothorax or pleural effusion . unremarkable xxxx . 
1259,1309_IM-0201-1001-0001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1260,1310_IM-0202-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is identified . 
1261,1311_IM-0203-1001.dcm.png,"low lung volumes with redemonstrated bronchovascular crowding . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the cardiac silhouette size is borderline enlarged . "
1262,1314_IM-0204-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . osseous structures intact . 
1263,1315_IM-0204-1001.dcm.png,"normal heart size . normal mediastinal silhouette . no pneumothorax , pleural effusion or suspicious focal air space opacity . "
1264,1316_IM-0205-1002.dcm.png,unknown
1265,1317_IM-0205-1001.dcm.png,lungs are clear . there is minimal atelectasis in the left base . no effusion or pneumothorax . heart and mediastinal contours within normal limits . density foreign body present in the soft tissues overlying the left lateral chest wall . visualized osseous structures intact . 
1266,1318_IM-0205-1001.dcm.png,the lungs are clear . no pleural effusion is seen . the heart and mediastinum are normal . arthritic changes of the spine are present . 
1267,1319_IM-0205-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1268,1320_IM-0207-1001.dcm.png,"calcified granuloma is noted in the left upper lobe . there are low lung volumes , with bronchovascular crowding as a result . heart size is within normal limits . normal mediastinal contours . no pleural effusion , pneumothorax or focal airspace disease . no free subdiaphragmatic air . the osseous structures are grossly intact . "
1269,1321_IM-0207-1001.dcm.png,unknown
1270,1322_IM-0208-3003.dcm.png,the lungs are clear . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours are normal . 
1271,1323_IM-0209-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
1272,1324_IM-0209-1001.dcm.png,no there is an dextroscoliosis of the thoracic spine . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
1273,1326_IM-0210-0001-0002.dcm.png,unknown
1274,1327_IM-0211-1001.dcm.png,"the heart is normal size with normal appearance the cardiomediastinal silhouette . there is no focal air space opacity , pleural effusion , or pneumothorax . the osseous structures are intact with degenerative changes in thoracic spine . "
1275,1329_IM-0211-1001.dcm.png,"two nodules are noted in the right measuring 13 mm and one measuring 16 mm in diameter . the smaller one appears to be within the right upper lobe and the large appears to be within the left lower lobe . no focal consolidation and no other pulmonary nodules are identified . however , if a full evaluation for lung nodules is desired consider for further evaluation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . "
1276,1330_IM-0213-1001.dcm.png,"heart size and cardiomediastinal silhouette are normal . lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . osseous structures are grossly intact . "
1277,1332_IM-0213-1001-0001.dcm.png,unknown
1278,1333_IM-0214-1001.dcm.png,"cardiomediastinal silhouette is within normal limits of size and appearance . pulmonary vascularity is unremarkable . morgagni hernia , stable . lungs are expanded and clear of air space disease or consolidation . negative for pneumothorax or pleural effusion . limited evaluation reveals diffuse demineralization with stable anterior wedging at the lower thoracic levels . "
1279,1334_IM-0214-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1280,1335_IM-0215-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
1281,1337_IM-0216-2001.dcm.png,unknown
1282,1339_IM-0218-1001.dcm.png,small 3 . 3 mm right-sided pneumothorax only visible on the left lateral decubitus film . left lung is clear . normal cardiac contour . no evidence of pleural effusion . 
1283,1339_IM-0218-2001.dcm.png,small 3 . 3 mm right-sided pneumothorax only visible on the left lateral decubitus film . left lung is clear . normal cardiac contour . no evidence of pleural effusion . 
1284,1340_IM-0220-1001.dcm.png,heart size is normal . no focal consolidations . no pneumothorax or pleural effusion . 
1285,1341_IM-0220-3001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . the distal tip of a right ij dual-lumen central venous catheter is at the which junction . 
1286,1342_IM-0221-1001.dcm.png,"mildly hyperinflated lungs with flattened posterior diaphragm . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . heart size within normal limits . no pneumothorax . "
1287,1343_IM-0222-0001-0002.dcm.png,there is mild cardiomegaly . the transverse is calcified . there is a moderate hiatal hernia . the lungs are clear without focal infiltrate . no pleural effusion or pneumothorax . degenerative changes of the thoracic spine are noted . 
1288,1344_IM-0223-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1289,1345_IM-0223-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1290,1346_IM-0224-4001.dcm.png,there is a right chest with catheter tip at the cavoatrial junction . heart size is at the upper limits of normal . lungs are grossly clear . no pleural effusion or pneumothorax . there are diffuse degenerative changes of the spine . 
1291,1346_IM-0224-8001.dcm.png,there is a right chest with catheter tip at the cavoatrial junction . heart size is at the upper limits of normal . lungs are grossly clear . no pleural effusion or pneumothorax . there are diffuse degenerative changes of the spine . 
1292,1347_IM-0225-4004.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
1293,1348_IM-0226-4004-0001.dcm.png,"the lungs are hypoinflated with mild basilar bronchovascular crowding/atelectasis . there is a fracture of the left anterior 7th rib and the left anterior 6th rib , of uncertain acuity . correlate with tenderness . there is mild atelectasis in the left lung base . there is corticated deformity of the right anterior 7th rib , remote fracture . there is no evidence of pneumothorax or large pleural effusion . "
1294,1348_IM-0226-4004-0002.dcm.png,"the lungs are hypoinflated with mild basilar bronchovascular crowding/atelectasis . there is a fracture of the left anterior 7th rib and the left anterior 6th rib , of uncertain acuity . correlate with tenderness . there is mild atelectasis in the left lung base . there is corticated deformity of the right anterior 7th rib , remote fracture . there is no evidence of pneumothorax or large pleural effusion . "
1295,1349_IM-0227-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified granuloma is identified . 
1296,1350_IM-0227-1001.dcm.png,chest . no focal consolidation . no visualized pneumothorax . no large pleural effusions . the heart size is normal . no focal thoracic bony findings . hand . there is also cortical and trabecular irregularity through the of the scaphoid . there is a small cortical lucency through the base of the fourth metacarpal that may be a vascular xxxx . 
1297,1351_IM-0228-1001.dcm.png,unknown
1298,1352_IM-0229-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is stable scarring in the right upper lobe . lungs are otherwise clear . there is no focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1299,1353_IM-0230-1001.dcm.png,"there is diffuse right-sided airspace disease , with dense consolidation in the right base . a right upper extremity picc is seen with the tip in the right brachiocephalic vein , representing an interval retraction of approximately 6 cm . no pneumothorax or large effusions . heart size within normal limits . "
1300,1354_IM-0230-1001.dcm.png,"the heart is normal in size and contour . the lung volumes are low with bronchovascular crowding . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1301,1355_IM-0230-1001.dcm.png,"low lung volumes with streaky bibasilar opacities , right greater than left . bronchovascular crowding , indistinct central vascular margination . no findings to suggest pleural effusion . accounting for technical factors heart size within normal limits . "
1302,1356_IM-0231-1001.dcm.png,"normal heart size . normal mediastinal contour . no pneumothorax , airspace consolidation , or pleural effusion . no chest xxxx . no acute bony abnormality . "
1303,1358_IM-0232-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are moderate degenerative changes in the thoracic spine . there are postsurgical clips in the right upper quadrant . "
1304,1358_IM-0232-3001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are moderate degenerative changes in the thoracic spine . there are postsurgical clips in the right upper quadrant . "
1305,1359_IM-0233-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
1306,1360_IM-0234-0001-0001.dcm.png,"there are opacities within both lung bases , representing atelectasis . heart size is upper limits of normal . no pneumothorax . no pneumothorax . "
1307,1361_IM-0235-1001.dcm.png,unknown
1308,1362_IM-0235-1001.dcm.png,unknown
1309,1363_IM-0236-0001-0002.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . negative for effusion , pneumothorax , or focal airspace consolidation . the lungs are normally aerated . "
1310,1364_IM-0237-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1311,1365_IM-0237-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . small rounded bilateral axillary densities not seen on the previous exam most suggestive of artifacts , healed right lateral 10th rib fracture noted . . "
1312,1366_IM-0237-1001.dcm.png,lungs are clear . heart size normal . the are unremarkable . 
1313,1367_IM-0237-1001.dcm.png,the heart size is normal . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
1314,1368_IM-0237-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1315,1369_IM-0238-1001.dcm.png,heart size normal . prominent epicardial fat . lungs are clear . no pleural effusion or pneumothorax . 
1316,1370_IM-0239-1001.dcm.png,"stable cardiomediastinal silhouette . there is mild haziness in the right lung and left base , which could represent infiltrate . no pleural effusion . no pneumothorax . stable deformity of a midthoracic vertebra . "
1317,1371_IM-0239-1001.dcm.png,unknown
1318,1372_IM-0239-1001.dcm.png,heart size is within normal limits . mild prominence of the mediastinum . bibasilar predominantly interstitial pulmonary opacities . no visualized pneumothorax . no pleural effusion . 
1319,1373_IM-0240-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
1320,1374_IM-0240-1001.dcm.png,normal heart size and mediastinal contours . clear lungs . no pneumothorax or pleural effusion . unremarkable xxxx . 
1321,1375_IM-0241-1001.dcm.png,unknown
1322,1375_IM-0241-3001.dcm.png,unknown
1323,1376_IM-0242-1001.dcm.png,sequelae of old granulomatous disease is again noted . lungs are clear without focal air space disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
1324,1377_IM-0242-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1325,1378_IM-0242-1001.dcm.png,heart size is normal . cardiomediastinal silhouette is normal in contour . the lungs are clear bilaterally without pleural effusion or pneumothorax . no pulmonary nodules . bony structures are intact . 
1326,1379_IM-0243-1001.dcm.png,heart size is within normal limits . no focal airspace disease . no pneumothorax or effusion . 
1327,1380_IM-0245-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1328,1381_IM-0245-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
1329,1382_IM-0245-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1330,1383_IM-0245-1001.dcm.png,there is significant interval decrease in right middle and right lower lobe opacification . persistent small right pleural effusion and atelectasis . no pneumothorax . stable appearance of the cardiomediastinal silhouette . no acute bone abnormality . 
1331,1384_IM-0246-1001.dcm.png,"the lungs are clear . there is no focal consolidation , pleural effusion , or pneumothorax . the heart and mediastinum are normal size and shape . and soft tissues are unremarkable . "
1332,1385_IM-0246-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . old healed left 5th and 6th rib fractures are seen laterally . "
1333,1386_IM-0246-1001.dcm.png,"the cardiac silhouette and upper mediastinum are within normal limits . there is no pulmonary venous congestion . there is prominence of the pulmonary arteries , right greater than left . there is no acute air space infiltrate , pleural effusion or pneumothorax . "
1334,1388_IM-0246-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . cholecystectomy . "
1335,1389_IM-0247-1001.dcm.png,unknown
1336,1390_IM-0249-1001.dcm.png,"the heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . vp shunt tubing is identified . the bony structures , as visualized , appear unremarkable . "
1337,1391_IM-0250-1001.dcm.png,"stable cardiomediastinal silhouette . low lung volumes . without focal consolidation , pneumothorax or pleural effusion . limited lateral view given overlapping tissue silhouettes . negative for acute bone abnormality . "
1338,1392_IM-0251-1001.dcm.png,"the aortic xxxx , cardiac apex , and stomach are left-sided . cardiomediastinal silhouette is within normal limits in overall size and appearance . pulmonary vascular markings are symmetric and within normal limits . the lungs are normally inflated with no focal airspace disease , pleural effusion , or pneumothorax . no acute bony abnormality . "
1339,1393_IM-0251-1001.dcm.png,right central venous line has been removed . heart size and pulmonary vascularity appear within normal limits . a few bandlike opacities are present at the lateral left base . the appearance scarring or atelectasis . no focal airspace disease is seen . no discrete nodules are identified . no pneumothorax or pleural effusion is seen . 
1340,1394_IM-0251-1001.dcm.png,unknown
1341,1395_IM-0251-1001.dcm.png,unknown
1342,1396_IM-0252-2001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1343,1397_IM-0253-1001.dcm.png,unknown
1344,1398_IM-0254-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . mild right basilar atelectasis and relative elevation of the right hemidiaphragm noted . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1345,1399_IM-0255-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . partial fusion of 2 vertebral bodies near the thoracolumbar junction . 
1346,1400_IM-0256-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1347,1401_IM-0256-1001.dcm.png,unknown
1348,1402_IM-0257-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
1349,1402_IM-0257-2001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
1350,1403_IM-0258-1001.dcm.png,heart size is normal . mild atelectasis . lungs are otherwise clear . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
1351,1404_IM-0258-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . no acute bony abnormalities . there are stable anterior wedge deformities of 2 midthoracic vertebral bodies . 
1352,1405_IM-0259-1001.dcm.png,there is scarring in the right mid and upper lung zone with surgical clips identified as well . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
1353,1406_IM-0259-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are hyperexpanded . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
1354,1407_IM-0260-1001.dcm.png,cardiac and mediastinal contours are within normal limits . right lung base granuloma . the lungs are otherwise clear . thoracic spondylosis . 
1355,1408_IM-0260-1001.dcm.png,"stable right upper lobe calcified granuloma . no pneumothorax , pleural effusion or airspace consolidation . normal heart size and pulmonary vasculature . are grossly intact . no thoracic fractures . "
1356,1409_IM-0260-1001.dcm.png,no focal consolidation . no visualized pneumothorax . heart size and cardiomediastinal silhouette are grossly unremarkable . no large pleural effusions . 
1357,1410_IM-0260-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1358,1411_IM-0261-0001-0001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . mild degenerative changes of the thoracic spine . 
1359,1412_IM-0262-1001.dcm.png,the lungs are clear . the heart and pulmonary appear normal . pleural spaces are clear . the mediastinal contours are normal . bony overlap in the lung apices could obscure a small pulmonary nodule . 
1360,1413_IM-0263-4004.dcm.png,heart size is within normal limits for ap technique . low lung volumes with bronchovascular crowding . no focal infiltrate . no visible pneumothorax . no pleural effusion . 
1361,1414_IM-0264-1001.dcm.png,unknown
1362,1415_IM-0264-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1363,1416_IM-0265-1001.dcm.png,"the cardiac silhouette is at the upper limits of normal for size . stable , mild prominence of the bilateral hilar regions . no focal areas of pulmonary consolidation . no pneumothorax . stable opacity in the left xxxx , representing a scar . no pleural effusion . minimal degenerative changes of the thoracic spine . no acute , displaced rib fractures . "
1364,1417_IM-0266-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . there are increased lucencies in the bilateral apices along with horizontal oblique scarring in the left upper lobe . this could suggest emphysematous bullae . are grossly unremarkable . "
1365,1418_IM-0267-2002.dcm.png,unknown
1366,1419_IM-0267-1001.dcm.png,cardiac silhouette and pulmonary vascularity are normal . there is mild bibasilar focal atelectasis . no evidence of pleural effusion or pneumothorax . minimal atherosclerotic changes are present in the thoracic aorta . 
1367,1420_IM-0268-1001.dcm.png,unknown
1368,1422_IM-0269-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no pneumothorax or pleural effusion . a wedge-shaped opacity has developed in the right upper lobe . there is also patchy opacification identified in the left upper lobe . no acute bony abnormality . 
1369,1423_IM-0270-1001.dcm.png,heart size upper limits normal . vascularity normal . calcified breast implants obscure some detail . lungs are clear . vascular calcifications aorta . no pleural effusions or pneumothoraces . 
1370,1424_IM-0271-2002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1371,1425_IM-0272-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1372,1426_IM-0272-1001.dcm.png,unknown
1373,1427_IM-0273-12012.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . there is a cardiac with leads terminating in the right atrium and right ventricle . there are atherosclerotic calcifications . 
1374,1428_IM-0274-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . heart size is normal . the cardiomediastinal silhouette is grossly unremarkable . 
1375,1429_IM-0275-1001.dcm.png,mediastinal contours are normal . heart size is within normal limits . lungs are clear . there is no pneumothorax or large pleural effusion . 
1376,1430_IM-0277-2001.dcm.png,"minimal patchy bibasilar airspace opacities , atelectasis or evolving pneumonia . the heart pulmonary appear normal . is minimal blunting of the pleural spaces , effusions . "
1377,1431_IM-0278-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
1378,1432_IM-0278-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
1379,1433_IM-0278-1001.dcm.png,the cardiac contours are normal . mild atherosclerosis . the lungs are clear . thoracic spondylosis . 
1380,1434_IM-0279-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1381,1435_IM-0280-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
1382,1436_IM-0280-1001.dcm.png,"the cardiac and mediastinal contours are within normal limits . there are calcifications of the aortic xxxx . the lungs are hyperinflated with increased retrosternal airspace and flattening of hemidiaphragms . there is haziness in the right lung apex . there is a 1 . 7 cm nodular density in the medial right lung base seen on the frontal view , not identified on the lateral view . this may represent a vessel on end . there is no consolidation , pneumothorax , or effusion . there are mild degenerative changes of the spine . "
1383,1437_IM-0281-3001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are hyperexpanded . scattered granuloma . no focal airspace disease . no large pleural effusion or pneumothorax . the are intact . 
1384,1438_IM-0282-1002.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1385,1439_IM-0282-1001.dcm.png,lungs are xxxx . opacities are present in the left lung base . heart size normal . mediastinum normal . 
1386,1440_IM-0284-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1387,1441_IM-0285-1001.dcm.png,the heart is normal in size . the mediastinum is within normal limits . there is retrocardiac density which corresponds to patient's known hiatal hernia . the lungs are hypoinflated . no focal consolidation is seen . 
1388,1442_IM-0286-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
1389,1443_IM-0286-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate increased interstitial markings probably copd . there is calcified hilar lymph xxxx . there is no effusion or pneumothorax . 
1390,1444_IM-0286-1001.dcm.png,there is a healing fracture involving the left posterolateral 7th rib . there is deformity of the 8th vertebral body . these bony lesions may be secondary to the patient's known multiple myeloma . the lungs appear clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
1391,1445_IM-0287-4004.dcm.png,stable cardiomediastinal silhouette . there has been interval removal of right chest tube with increased elevation of the right hemidiaphragm and right basilar atelectasis . left basilar consolidation and pleural effusions seen . no focal consolidation or pneumothorax . there is a stable left picc with tip overlying the mid svc and large feeding tube courses below the diaphragm . 
1392,1446_IM-0288-1001.dcm.png,unknown
1393,1447_IM-0289-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures short thready changes of the spine . 
1394,1448_IM-0289-1001.dcm.png,and lateral views of the chest were obtained on 02/010/xxxx . the lung volumes are normal . the lungs are clear and there are no pleural effusions . there is stable mild tenting of the medial aspect of the right diaphragm . the mediastinum and pulmonary are normal . the bony elements are not remarkable . 
1395,1449_IM-0290-1001.dcm.png,"the cardiac silhouette is enlarged with no comparison studies . findings are accentuated by low lung volumes and eventration of the anterior right hemidiaphragm , however , cardiomegaly or less xxxx , pericardial effusion is suspected . the lungs are hypoinflated with central bronchovascular crowding but no evidence of overt pulmonary edema . the lungs are grossly clear of focal airspace disease , pneumothorax , pleural effusion . there are no acute bony findings . there are degenerative changes of the thoracic spine . patient appears morbidly obese . "
1396,1450_IM-0291-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . "
1397,1451_IM-0291-1001.dcm.png,left lower lobe calcified granuloma . heart size normal . no pleural effusion or pneumothorax . mild medial right atelectasis . mild emphysema . 
1398,1452_IM-0291-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . no pneumothorax , pleural effusion , or focal air space consolidation . "
1399,1453_IM-0292-12012.dcm.png,"normal cardiomediastinal contours , given patient position and technique . no pneumothorax or large pleural effusions . the lung volumes . "
1400,1454_IM-0293-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1401,1455_IM-0293-1001.dcm.png,the lungs are clear . a calcified granuloma is seen in the left midlung zone . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
1402,1456_IM-0294-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . the heart size and cardiomediastinal silhouette are grossly unremarkable . 
1403,1458_IM-0296-1001.dcm.png,"stable cardiomegaly and mediastinal contour . lungs are clear without focal consolidation , large pleural effusion , or pneumothorax . left basilar airspace opacity secondary to epicardial fat and overlying soft tissues . dish of the thoracic spine is noted . otherwise , visualized osseous structures are unremarkable . "
1404,1459_IM-0297-1001.dcm.png,"no stable cardiomegaly , without focal consolidation , pneumothorax , or pleural effusion . stable right basilar calcified granuloma . no acute osseous abnormality identified . "
1405,1459_IM-0297-3001.dcm.png,"no stable cardiomegaly , without focal consolidation , pneumothorax , or pleural effusion . stable right basilar calcified granuloma . no acute osseous abnormality identified . "
1406,1460_IM-0298-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1407,1461_IM-0299-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1408,1462_IM-0299-1001.dcm.png,"no gross consolidation , atelectasis or infiltrate . no pleural fluid collection or pneumothorax . cardiomediastinal silhouette is within normal limits . is intact . "
1409,1463_IM-0300-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
1410,1464_IM-0301-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a calcified granuloma in the left lung base . "
1411,1465_IM-0302-1001.dcm.png,"the heart is normal in size . stable appearance of coronary stent . sternotomy changes are present . no focal consolidation , pneumothorax or pleural effusion . mild degenerative changes of the thoracic spine . "
1412,1466_IM-0302-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
1413,1467_IM-0302-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1414,1468_IM-0303-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
1415,1469_IM-0303-1001.dcm.png,there is no focal airspace consolidation or pleural effusion . heart size is normal . no pneumothorax . 
1416,1470_IM-0303-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1417,1471_IM-0304-2001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the lungs are hyperexpanded with flattening of the bilateral hemidiaphragms . mild increased lung markings due to chronic changes . no focal pulmonary consolidation . no pneumothorax . no pleural effusion . moderate degenerative changes of the thoracic spine . calcified left perihilar granuloma redemonstrated . 
1418,1472_IM-0305-1001.dcm.png,normal cardiac contour . clear hyperexpanded lungs bilaterally with no pneumothorax or pleural effusion . 
1419,1473_IM-0306-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
1420,1474_IM-0307-1001.dcm.png,no pneumothorax . heart size is normal . granulomas are seen within the right lung . no large pleural effusions . no focal airspace consolidation . 
1421,1475_IM-0307-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . vague nodular density right upper lobe overlying the right anterior 2nd and posterior 6th ribs . this could represent healing fracture or superimposed structures . bony thorax is unremarkable . "
1422,1476_IM-0308-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1423,1477_IM-0309-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
1424,1478_IM-0310-0001-0002.dcm.png,"stable cardiomediastinal silhouette with normal heart size , mediastinal calcifications suggest a previous granulomatous process . apical irregularities also present on the previous exam suggestive of scarring . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
1425,1478_IM-0310-0001-0003.dcm.png,"stable cardiomediastinal silhouette with normal heart size , mediastinal calcifications suggest a previous granulomatous process . apical irregularities also present on the previous exam suggestive of scarring . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
1426,1479_IM-0311-1001.dcm.png,unknown
1427,1480_IM-0311-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
1428,1481_IM-0312-3001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax or large pleural effusion . "
1429,1482_IM-0313-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
1430,1483_IM-0313-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there is eventration of the right hemidiaphragm . the descending thoracic aorta is tortuous . 
1431,1484_IM-0313-1001.dcm.png,calcified left lower lobe granuloma . no focal areas of consolidation . no pleural effusions . no pneumothorax . degenerative changes noted of the thoracic spine . 
1432,1485_IM-0313-1001.dcm.png,again seen are platelike horizontal opacities in both lung bases through this is consistent with scarring or subsegmental atelectasis . there are t-spine osteophytes . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there there is no lobar pneumonia . there are calcified right hilar granuloma . there are degenerative changes of the xxxx . there is a curvilinear density within and along the right costophrenic sulcus which most represents a skinfold . there is a unchanged fracture with callus at the left 9th lateral rib . 
1433,1487_IM-0314-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1434,1488_IM-0315-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1435,1489_IM-0315-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
1436,1491_IM-0317-1001.dcm.png,"there are low lung volumes . the lungs are otherwise clear . no focal airspace consolidation or pleural effusion . calcific density in the right lung apex , compatible with calcified granuloma . "
1437,1492_IM-0318-4004.dcm.png,the lungs are clear . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours are normal . there is stable lucency in the right mid clavicle dating back to xxxx . 
1438,1493_IM-0318-1001.dcm.png,unknown
1439,1494_IM-0319-4001.dcm.png,unknown
1440,1496_IM-0320-1001.dcm.png,unknown
1441,1497_IM-0321-1001.dcm.png,the heart size size and pulmonary vascularity appear within normal limits . ill-defined opacity is again noted in the region of the lingula . this is increased since the previous study . the remainder of the lungs appear clear . mild deformity is noted in the mid-thoracic spine . no pneumothorax or pleural effusion is seen . 
1442,1498_IM-0322-2001.dcm.png,"apical lordotic frontal view . heart size within normal limits , mild aortic ectasia/tortuosity . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . chronic appearing contour irregularity of the distal left clavicle and widening may be posttraumatic or postsurgical , verterbroplasty noted at the thoracolumbar junction . "
1443,1499_IM-0323-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . low lung volumes . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
1444,1500_IM-0326-9001.dcm.png,"normal heart size . aortic calcification . granulomatous nodule left midlung , stable . no acute pulmonary abnormalities . thoracic spondylosis . "
1445,1501_IM-0327-1001.dcm.png,chest . right hemidiaphragm remains elevated . consolidation and atelectasis are present in the right lung base . left lung is clear . no pleural air collections . shoulder and clavicle . fractures present in the right scapula the base of the glenoid process . it is attached to the coracoid process and a portion of the spine . the humeral head is located within the glenoid articular surface . cutaneous air is present . fracture is present in the posterior portion of the right 3rd rib . the acromioclavicular joint and coracoclavicular joints are widened . 
1446,1502_IM-0328-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
1447,1503_IM-0329-5001.dcm.png,unknown
1448,1504_IM-0330-1001.dcm.png,unknown
1449,1505_IM-0330-1001.dcm.png,normal heart size . clear lungs . no pneumothorax . no pleural effusion . there is opacity at the base of the mediastinum which is a hiatal hernia . 
1450,1506_IM-0330-1001.dcm.png,"there is interval placement of a on the left chest with the catheter tip in the cavoatrial junction . the heart size is within normal limits . lung volumes within normal limits . slightly prominent pulmonary vascularity noted . increased peribronchial cuffing . no large consolidation , effusion , or pneumothorax . there is subpleural edema outlining the right fissure . "
1451,1508_IM-0330-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1452,1509_IM-0331-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
1453,1510_IM-0331-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1454,1511_IM-0331-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1455,1512_IM-0332-2002.dcm.png,the lungs appear clear . the heart and pulmonary are normal . pleural spaces are clear . the mediastinal contours are normal . 
1456,1513_IM-0333-1001.dcm.png,there is mild streakiness in the right base . no focal infiltrate or effusion . no pneumothorax . calcified granulomatous disease noted . heart and mediastinal contours within normal limits . osseous structures intact . 
1457,1514_IM-0333-1001.dcm.png,"cardiomediastinal silhouette is within normal limits of size and appearance . the pulmonary vascularity is unremarkable . there are opacities in the left xxxx , subsegmental atelectasis or scar . otherwise , the lungs are expanded and clear of airspace disease . negative for pneumothorax or pleural effusion . limited bone evaluation reveals no acute abnormality . "
1458,1515_IM-0333-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
1459,1516_IM-0334-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1460,1517_IM-0335-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1461,1518_IM-0335-1003.dcm.png,"no focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is stable and unremarkable . no acute osseous abnormalities are identified . "
1462,1519_IM-0335-4004.dcm.png,"lungs are mildly hypoinflated with asymmetric elevation of the right hemidiaphragm , of uncertain chronicity . there is mild basilar bronchovascular crowding , without evidence of focal airspace disease . heart is within normal limits for low lung volumes and ap technique . there is no pneumothorax or large pleural effusion . "
1463,1520_IM-0336-1002001.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . postsurgical changes of the cervical spine are present . "
1464,1521_IM-0337-1001.dcm.png,three images are available for review . the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1465,1521_IM-0337-3001.dcm.png,three images are available for review . the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1466,1522_IM-0338-0001-0002.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are unchanged . "
1467,1523_IM-0339-1001.dcm.png,"heart size , cardiomediastinal silhouette , and pulmonary vasculature are within normal limits . there are no infiltrates , effusions , or pneumothorax . "
1468,1524_IM-0339-1001.dcm.png,"heart size is normal . the aorta is tortuous , and cannot exclude ascending aortic aneurysm . the pulmonary vascularity is normal . there residual to prior granulomatous infection . lungs are otherwise clear . degenerative change of the spine . "
1469,1525_IM-0340-3001.dcm.png,"4 images . there is a large hydropneumothorax within the left chest . there is essentially complete collapse of the left lung . within the right lung , there are increased interstitial opacities within the medial right lung base and right upper lobe , with patchy airspace opacity within the right lung apex . at the right lung apex , there is a more focal ovoid lucency which measures approximately 1 . 3 cm . this could indicate cavitation . left-sided cardiomediastinal contours are obscured by collapse of the left lung . no convincing acute bony findings . "
1470,1525_IM-0340-4001.dcm.png,"4 images . there is a large hydropneumothorax within the left chest . there is essentially complete collapse of the left lung . within the right lung , there are increased interstitial opacities within the medial right lung base and right upper lobe , with patchy airspace opacity within the right lung apex . at the right lung apex , there is a more focal ovoid lucency which measures approximately 1 . 3 cm . this could indicate cavitation . left-sided cardiomediastinal contours are obscured by collapse of the left lung . no convincing acute bony findings . "
1471,1526_IM-0341-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . the heart size and cardiomediastinal silhouette is grossly unremarkable . there is motion artifact on the lateral radiograph . 
1472,1527_IM-0341-1001-0002.dcm.png,"heart size slightly upper normal . atherosclerotic calcifications within the aorta . . lungs are hyperexpanded with flattening of the diaphragms consistent with emphysematous change . no focal airspace disease , pleural effusion , or pneumothorax . degenerative changes of the spine are noted . "
1473,1528_IM-0341-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . note is of an closure device which appears grossly appropriate the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
1474,1529_IM-0342-0001-0001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size is within normal limits . right paratracheal density is stable from prior radiographs and may reflect tortuous vasculature . there is aortic atherosclerotic vascular calcification . there are mild degenerative changes of the spine . surgical clips are noted in the region of the left breast . there is mild diaphragm eventration . 
1475,1530_IM-0344-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1476,1531_IM-0344-1001.dcm.png,"heart size within normal limits , stable mediastinal contours with aortic ectasia/tortuosity . left hilar and left lower lobe calcifications indicate a previous granulomatous process . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . "
1477,1532_IM-0344-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1478,1533_IM-0344-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
1479,1534_IM-0345-4004.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . aortic atherosclerosis . hyperexpanded lungs . right perihilar/midlung density . streaky bibasilar opacities , as well . left upper lobe nodular opacity ( anterior first rib interspace ) may be exaggerated by overlapping bone silhouettes . grossly similar midthoracic vertebral fracture . "
1480,1535_IM-0346-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1481,1536_IM-0347-0001-0001.dcm.png,unknown
1482,1537_IM-0348-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
1483,1538_IM-0348-1001.dcm.png,normal heart size is prominent left ventricular contour . unfolding of the thoracic aorta . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable appearance . 
1484,1539_IM-0349-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
1485,1540_IM-0351-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
1486,1541_IM-0352-1001.dcm.png,unknown
1487,1542_IM-0352-1001.dcm.png,the heart is top normal in size . the mediastinum is stable . the aorta is atherosclerotic . opacities are noted in the lung bases compatible with scarring or atelectasis . there is no acute infiltrate or pleural effusion . 
1488,1543_IM-0353-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . large hiatal hernia . "
1489,1544_IM-0354-1001.dcm.png,normal heart . clear lungs . no pneumothorax . no pleural effusion . 
1490,1545_IM-0355-2002.dcm.png,no focal areas of consolidation . no pneumothorax . heart size within normal limits . no pleural effusions . osseous structures intact . 
1491,1546_IM-0356-3001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1492,1547_IM-0357-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . prominent left epicardial fat xxxx . 
1493,1548_IM-0357-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . small t-spine osteophytes . 
1494,1549_IM-0357-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1495,1550_IM-0359-1001.dcm.png,"heart size , cardiomediastinal silhouette , and pulmonary vasculature are within normal limits . there are no infiltrates , effusions , or pneumothorax . "
1496,1551_IM-0359-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute , displaced rib fractures . "
1497,1552_IM-0360-1001.dcm.png,"low lung volumes . cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . mild left lingular platelike atelectasis . are grossly unremarkable . "
1498,1553_IM-0360-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . no pleural effusion . there are spine marginal osteophytes . "
1499,1554_IM-0361-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . multilevel degenerative changes of the thoracic spine are noted . 
1500,1555_IM-0362-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette and mediastinal contours are not enlarged . there is elevated right hemidiaphragm and evidence of right upper lobectomy . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
1501,1556_IM-0363-1001.dcm.png,heart size appears upper limits of normal . tortuous aorta . otherwise normal mediastinum . confluent and opacities seen within the left base . there are no visible nodules or masses . no visible pneumothorax . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1502,1557_IM-0364-4004.dcm.png,"there is interval removal of the tracheostomy tube and right subclavian central venous catheter . the cardiac silhouette is mildly enlarged . there are pulmonary opacities with blunting of the bilateral costophrenic xxxx , on the right greater than left , with pleural thickening versus loculated pleural fluid along the peripheral aspect of the right upper lobe . right perihilar opacities . no pneumothorax identified . "
1503,1558_IM-0365-1001.dcm.png,low lung volumes . cardiomediastinal silhouette is within normal limits of size and appearance . pulmonary vascularity is within normal limits . lungs are clear airspace disease . negative for pneumothorax or pleural effusion . are grossly intact . 
1504,1559_IM-0365-2001.dcm.png,"stable cardiomediastinal silhouette . right hilar surgical clips . stable right-sided volume loss . increasing density in the superior segment of the left lower lobe , seen on lateral view . no pneumothorax . severe degenerative disease of the xxxx . "
1505,1560_IM-0366-1001.dcm.png,normal heart . clear lungs . no pneumothorax . no pleural effusion . 
1506,1561_IM-0367-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . soft tissues unremarkable"
1507,1562_IM-0367-1001.dcm.png,"low lung volumes with magnified appearance of the heart , normal heart size . negative for consolidation , effusion , or pneumothorax . bony thorax and soft tissues grossly unremarkable . "
1508,1563_IM-0368-1001.dcm.png,heart size within normal limits . no focal airspace opacities . no pneumothorax . no effusions . mild degenerative changes of the thoracic spine . no deformities . emphysematous changes . 
1509,1564_IM-0368-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours , coronary artery stent artifact , and clips suggest cabg . mediastinal and hilar calcifications indicate a previous granulomatous process . stable hyperinflation , bilateral upper lobe pleuroparenchymal near and nodular irregularities , right greater than left , opacities in the peripheral right lung most compatible with scarring . no abnormal pulmonary opacities , no definite pleural effusion seen . no typical findings of pulmonary edema . osseous demineralization , stable appearance of t9 and t12 fractures . "
1510,1565_IM-0368-1001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . there is no pneumothorax , pleural effusion , or focal air space consolidation . mild basilar atelectasis . increased density the lung bases , favored this attenuation from overlying breast shadows . "
1511,1566_IM-0369-1001.dcm.png,unknown
1512,1567_IM-0370-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . opacity in left midlung . the lungs are clear . 
1513,1568_IM-0371-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated but clear . 
1514,1569_IM-0372-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart and mediastinum are normal . the skeletal structures show arthritic changes . 
1515,1570_IM-0372-1001.dcm.png,evaluation for pneumothorax is limited due to exclusion of the superior-most pulmonary apices . no visible pleural xxxx . no focal air space opacities or pleural effusion . cardiomediastinal silhouette is within normal limits . no free subdiaphragmatic air . mild degenerative changes of the thoracic spine . included osseous structures are grossly intact . 
1516,1572_IM-0373-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there is redemonstration of a calcified granuloma within the left upper lobe . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1517,1573_IM-0374-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1518,1574_IM-0374-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1519,1575_IM-0374-1001.dcm.png,unknown
1520,1576_IM-0375-1001.dcm.png,lumbar and are low . no infiltrates . heart size normal . a large hiatal hernia is present . an age-indeterminate fracture is present in the lower thoracic vertebra . scoliosis is present in the thoracic and thoracolumbar spine . 
1521,1577_IM-0375-1001.dcm.png,"heart size is normal . low lung volumes . no pneumothorax , pleural effusion , or focal airspace disease . bony structures grossly intact . "
1522,1578_IM-0376-5001.dcm.png,"cardiac and mediastinal appear normal . low lung volumes and bronchovascular crowding . no visible pneumothorax , focal airspace opacity , or pleural effusion is seen . no visible free air under the diaphragm . the osseous structures appear intact . surgical clips are seen within the right upper abdomen . "
1523,1579_IM-0376-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
1524,1580_IM-0378-1001.dcm.png,lungs are mildly hyperexpanded . the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . there are diffuse degenerative changes of the spine . 
1525,1581_IM-0378-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . there are 2 right upper lobe lung nodules , the largest measuring approximately 12 mm . lungs are without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
1526,1582_IM-0378-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1527,1583_IM-0378-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . mild spine curvature noted . "
1528,1584_IM-0379-1001.dcm.png,"the lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . degenerative changes of the thoracic spine . "
1529,1585_IM-0380-1001.dcm.png,"sternotomy and mediastinal clips are unchanged . cardiomediastinal silhouette is unchanged . pulmonary vasculature and are unchanged . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are unchanged . "
1530,1586_IM-0380-1001.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . the lungs are clear bilaterally . no focal opacities . there is no large pleural effusion . no pneumothorax . there is deformities involving multiple vertebral bodies of the thoracic spine which appear stable compared to the previous exam . 
1531,1587_IM-0381-1002001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is within limits . postoperative changes from spinal rods are demonstrated . there is elevation of the left hemidiaphragm . multiple colonic loops are demonstrated in the left upper quadrant . the lungs are clear bilaterally . left humeral head is positioned anterior and inferior to the glenoid , concerning for anterior shoulder subluxation . "
1532,1588_IM-0382-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1533,1589_IM-0382-1001.dcm.png,"the lungs are hyperinflated with mildly coarsened interstitial markings consistent with chronic lung disease . no focal consolidation , pneumothorax , or effusion identified . the mediastinal silhouette is stable and within normal limits for size . there is redemonstration without significant change in right hilar calcified lymph xxxx . the bony structures of the thorax demonstrate degenerative changes of the right shoulder and a right humerus consistent with distal humeral amputation . no acute bony abnormality identified . "
1534,1590_IM-0383-4001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1535,1591_IM-0384-13013.dcm.png,the trachea is midline . the cardio mediastinal silhouette is of normal size and contour . no evidence of focal infiltrate or effusion . low lung volumes atelectasis and bronchovascular crowding . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals degenerative changes of the thoracic spine . 
1536,1592_IM-0385-1001.dcm.png,stable cardiomediastinal silhouette with borderline cardiomegaly . no pneumothorax or large pleural effusion . no focal airspace disease . diffuse interstitial opacities . bony structures appear intact . nodular densities consistent with chronic granulomatous disease . 
1537,1593_IM-0385-1001.dcm.png,moderate sized right loculated pleural effusion with right lower lobe atelectasis . normal cardiac contour with atherosclerotic changes throughout the aorta . clear left lung xxxx . 
1538,1594_IM-0385-1001.dcm.png,"the heart and cardiomediastinal silhouette are normal in size and shape . there is no focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
1539,1595_IM-0386-2001.dcm.png,the heart is large . lung volumes are xxxx . opacity persists in the right midlung . no focal infiltrates . 
1540,1596_IM-0387-1001.dcm.png,normal heart . clear lungs . stable calcified granuloma left midlung . no pneumothorax . no pleural effusion . midline trachea . 
1541,1597_IM-0388-1001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
1542,1598_IM-0389-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , pleural effusion , or pneumothorax is identified . no acute osseous abnormality identified . "
1543,1599_IM-0389-1001.dcm.png,"normal heart size , mediastinal and aortic contours . normal pulmonary vascularity . atherosclerotic calcifications identified within the aortic xxxx . the lungs are clear . no focal consolidation , visible pneumothorax or large pleural effusion . flowing thoracic spine osteophytes noted . "
1544,1600_IM-0390-1001.dcm.png,"the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size is at the upper limits of normal . thoracic aorta is mildly ectatic , stable . old right clavicular fracture is again noted . "
1545,1601_IM-0390-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
1546,1602_IM-0390-1001.dcm.png,unknown
1547,1603_IM-0391-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1548,1604_IM-0392-1001.dcm.png,unknown
1549,1605_IM-0393-3001.dcm.png,unknown
1550,1608_IM-0394-1001.dcm.png,"the cardiac silhouette , upper mediastinum and pulmonary vasculature are within normal limits . there is no acute air space infiltrate , pleural effusion or pneumothorax . no pulmonary nodules are identified . "
1551,1609_IM-0394-1001.dcm.png,"calcified lymph in both xxxx . amount of focal atelectasis posterior to the left heart . the trachea is midline . negative for pneumothorax , pleural effusion or large focal airspace consolidation . the heart size is normal . "
1552,1610_IM-0395-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1553,1612_IM-0397-1001.dcm.png,mild cardiomegaly . tortuous thoracic aorta with atherosclerosis . no pneumothorax or pleural effusion . degenerative changes in the thoracic spine without evidence of deformity . the visualized osseous structures are intact . no displaced rib fractures . no edema or airspace consolidation
1554,1614_IM-0397-1001.dcm.png,unknown
1555,1615_IM-0398-4004.dcm.png,unknown
1556,1616_IM-0399-1001.dcm.png,"chest . lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . ribs . there are no displaced rib fractures , or obvious nondisplaced rib fractures . soft tissues appear normal . "
1557,1617_IM-0399-1001.dcm.png,the cardiac contours are normal . calcified tortuous thoracic aorta . emphysema . mild apical scarring . the lungs are otherwise clear . thoracic spondylosis . 
1558,1618_IM-0399-1001.dcm.png,unknown
1559,1619_IM-0400-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are mildly hypoinflated but clear of focal airspace disease , pneumothorax , or pleural effusion . there are multiple sternotomy and surgical clips compatible with prior cabg . the most caudal sternotomy is fractured . there are no acute bony findings . "
1560,1620_IM-0402-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . the lungs are clear without areas of focal consolidation . no pneumothorax or pleural effusion . lucency under the right hemidiaphragm may represent a focus of free air . 
1561,1621_IM-0403-1001.dcm.png,"the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is at the upper limits of normal . calcified granuloma in the right lower lobe is stable in appearance compared to the previous examinations . "
1562,1622_IM-0404-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . . "
1563,1623_IM-0405-4004.dcm.png,"normal cardiomediastinal contours . no pneumothorax , pleural effusions or focal lung consolidation . "
1564,1624_IM-0406-1001.dcm.png,"heart size mildly enlarged , stable mediastinal and hilar contours , mediastinal calcifications suggest a previous granulomatous process . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
1565,1625_IM-0406-1002.dcm.png,the heart is normal in size . the mediastinum is stable . atherosclerotic calcifications of the aortic are present . the lungs are clear . 
1566,1626_IM-0407-1001.dcm.png,"the heart is normal in size . the mediastinal contours are within normal limits . there are numerous bilateral pulmonary nodules of varying sizes . the largest is noted in the left lower lobe , posteriorly measuring approximately 7 . 0 cm . no acute infiltrate or pleural effusion are appreciated . "
1567,1627_IM-0408-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . . 
1568,1630_IM-0411-1001.dcm.png,"2 images . there is a poorly defined lung nodule in the right upper lobe measuring approximately 7 mm and partially superimposed upon anterior right second rib . otherwise , the lungs are clear . no pleural effusion or pneumothorax . heart size is normal . critical result notification documented through primordial . "
1569,1631_IM-0412-0001-0001.dcm.png,"there are a few small nodular opacities in the left lung , seen on the frontal view overlying the left 6th posterior rib . lungs otherwise appear clear . no focal airspace consolidation . no overt pulmonary edema . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . calcified mediastinal and hilar lymph are consistent with prior granulomatous disease . there are mild degenerative changes of the spine . "
1570,1632_IM-0413-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1571,1633_IM-0414-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1572,1633_IM-0414-3001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1573,1634_IM-0414-2002.dcm.png,calcified granulomas . calcified hilar xxxx . no focal areas of consolidation . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . question large pulmonary arteries . lung are hyperexpanded . prominent substernal air space . aortic calcifications . degenerative changes thoracic spine . 
1574,1635_IM-0415-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified granuloma is present in the right lung base . bibasilar bandlike opacities are present . the appearance scarring or atelectasis . 
1575,1636_IM-0415-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
1576,1637_IM-0416-1001.dcm.png,"no acute osseous abnormality . mild degenerative changes of the thoracic spine . there is stable enlargement of the heart . no focus of consolidation , pleural effusion , or pneumothorax . "
1577,1638_IM-0417-1001.dcm.png,"study is somewhat limited by body habitus . cardiomegaly is noted , with central pulmonary vascular prominence and coarsened interstitial markings , suspicious for developing interstitial pulmonary edema . no focal consolidation , pneumothorax , or definite effusion identified . no acute bony abnormality seen . "
1578,1639_IM-0418-1001.dcm.png,the lungs are relatively clear with sulci . heart size normal in lv contour . slightly unfolded ascending and descending aorta . t-spine unremarkable . 
1579,1640_IM-0420-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . small nodule in the right upper lung is stable . the lungs are otherwise clear . 
1580,1641_IM-0420-1001.dcm.png,two views of chest was obtained in ap projection . the cardiomediastinal silhouette is not enlarged . lungs demonstrate segmental air space disease within the left lower lobe . there is no effusion or pneumothorax . there is evidence of cabg . 
1581,1642_IM-0421-2001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart size is normal with postoperative changes consistent with cabg . degenerative changes in the thoracic spine . 
1582,1643_IM-0421-1001.dcm.png,"3 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1583,1645_IM-0422-1001.dcm.png,stable chronic appearing left basilar opacities . no focal areas of consolidation . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures appear intact . degenerative changes of the visualized thoracic spine . 
1584,1646_IM-0423-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1585,1647_IM-0424-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1586,1648_IM-0425-0001-0001.dcm.png,the lungs are mildly hyperexpanded . there is no focal airspace consolidation . no suspicious pulmonary mass or nodule is identified . heart size and mediastinal contour are within normal limits . there are degenerative changes of the spine . 
1587,1649_IM-0426-1001.dcm.png,"there is a moderate layering left pleural effusion , grossly stable . there is a moderate right pleural effusion , which is partially loculated . there is some pleural fluid tracking along the right fissure . there is bibasilar airspace disease , possibly passive atelectasis . no pneumothorax is identified . heart size is within normal limits . right picc tip is at the svc . there are mild degenerative changes of the spine . "
1588,1650_IM-0427-1001.dcm.png,unknown
1589,1651_IM-0427-1001.dcm.png,unknown
1590,1652_IM-0428-1001.dcm.png,dextroscoliosis of the thoracic spine . clear lungs bilaterally . no pneumothorax or pleural effusion . no acute bony abnormalities . 
1591,1654_IM-0430-1001.dcm.png,"the heart and mediastinum are unremarkable . there is tortuosity of the aorta , compatible with atherosclerosis . low lung volumes . minimal opacities within the lung bases , subsegmental atelectasis . the lungs are clear without infiltrate . there is no effusion or pneumothorax . "
1592,1655_IM-0431-1001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . there is no pneumothorax , pleural effusion , or focal air space consolidation . degenerative spine . "
1593,1656_IM-0431-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . 
1594,1657_IM-0432-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1595,1659_IM-0434-1001.dcm.png,"heart size within normal limits . no focal airspace disease . no pneumothorax , no pleural effusion . no displaced rib fractures . "
1596,1660_IM-0436-1001.dcm.png,there are low lung volumes . the lungs are otherwise clear . heart size is normal . no pneumothorax . 
1597,1661_IM-0437-1001.dcm.png,unknown
1598,1662_IM-0438-1001.dcm.png,"no focal consolidation . there are prominent interstitial markings , including focally in right upper lobe , which are similar from prior examination . no visualized pneumothorax . the heart size is normal . there are no pleural effusions . "
1599,1663_IM-0439-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
1600,1664_IM-0439-1001.dcm.png,unknown
1601,1665_IM-0439-1001.dcm.png,normal cardiac contour . stable calcified granuloma left upper lobe . no pleural effusion or pneumothorax . clear lungs bilaterally . 
1602,1666_IM-0440-0001-0001.dcm.png,"the cardiac silhouette is mildly enlarged . there are scattered bilateral opacities , most notably in the right middle lobe , of subsegmental atelectasis . no pleural effusion . no pneumothorax is identified . there are diffuse degenerative changes of the spine . "
1603,1667_IM-0441-1001.dcm.png,the cardiac and mediastinal silhouettes are normal . the lungs are well-expanded and clear . there is no focal airspace opacity . there is no pneumothorax or effusion . there is irregularity of the 7th posterior right rib with underlying pleural thickening . 
1604,1668_IM-0441-1001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . there is a discrete 1 . 4 cm nodule within the anterior segment of the right lower lobe . the additional nodular opacities consistent with chronic granulomatous disease . heart size normal . cardiomediastinal silhouette is clear . bony structures appear intact . right unilateral nipple ring . "
1605,1669_IM-0441-1001.dcm.png,"the lungs are clear , and without focal air space opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there are calcifications in the aortic xxxx . there is a calcified granuloma at the left lower lung . there is no pneumothorax or large pleural effusion . "
1606,1670_IM-0441-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . xxxx-a-xxxx has its tip at the caval atrial junction . 
1607,1671_IM-0442-1001.dcm.png,"heart size and mediastinal contours are within normal limits . there is no pneumothorax , pleural effusion , focal airspace consolidation . "
1608,1672_IM-0443-4001.dcm.png,unknown
1609,1673_IM-0444-1001.dcm.png,heart size is normal in cardiomediastinal silhouette is normal in contour . the lungs are clear bilaterally . no consolidations . no pleural effusion . no pneumothorax . and soft tissues are unremarkable . lungs are hyperinflated . 
1610,1674_IM-0445-1001.dcm.png,the previously seen right-sided picc has been removed . the heart size is normal . lungs are clear . there is no pneumothorax or large pleural effusion . bony structures are within normal limits . 
1611,1675_IM-0445-1001.dcm.png,lung volumes remain low . no infiltrates . heart and pulmonary remain normal . 
1612,1676_IM-0445-1001.dcm.png,"heart size and mediastinal contour within normal limits . aortic atherosclerotic calcifications . emphysematous changes . nodular densities projecting over right anterior fifth and six ribs . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
1613,1677_IM-0446-1001.dcm.png,"the cardiac and mediastinal silhouettes are unremarkable . the lungs are well expanded and clear . there is no focal air space opacity , pneumothorax , or effusion . the bony structures of the thorax are intact with no evidence of acute abnormality . . "
1614,1678_IM-0447-0001-0001.dcm.png,"the heart is normal in size . the mediastinum is stable . right chest tip is again seen at the cavoatrial junction . there is no pneumothorax . there is again elevation of right hemidiaphragm with right-sided pleural effusion . vague opacities are noted in the right upper lobe , from prior study . these may be related to overlying rib lesions versus true pulmonary nodules . the left lung appears grossly clear . drainage catheter seen overlying the right upper quadrant . "
1615,1679_IM-0448-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1616,1680_IM-0448-1001.dcm.png,unknown
1617,1681_IM-0448-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1618,1682_IM-0449-1001.dcm.png,"there is a lobulated contour to the right paratracheal stripe , possibly consistent with a vascular structure or lymph xxxx . the cardiomediastinal silhouette is otherwise within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . "
1619,1683_IM-0449-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . there are diminished lung volumes . right greater than left bilateral hilar and subcarinal adenopathy is again seen . the cardiac silhouette is prominent but probably artifactually large due to diminished lung volumes . no focal consolidation , pleural effusion , or pneumothorax identified . there is a deformity of the left clavicle compatible with remote xxxx . "
1620,1684_IM-0449-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
1621,1685_IM-0449-1001.dcm.png,"hyperinflated lungs with mildly flattened posterior diaphragm . no focal alveolar consolidation , no definite pleural effusion seen . heart size within normal limits , no typical findings of pulmonary edema . "
1622,1686_IM-0450-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . no change calcified aorticopulmonary node . 
1623,1687_IM-0450-1001.dcm.png,feeding tube noted with tip distal to the gastroesophageal junction . no focal areas of consolidation . heart size within normal limits . no pleural effusions . osseous structures intact . 
1624,1688_IM-0450-1001.dcm.png,heart size is normal and cardiomediastinal contours are normal . lungs are otherwise clear bilaterally without effusion or pneumothorax . bony structures and soft tissues are unremarkable . 
1625,1689_IM-0451-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1626,1690_IM-0452-1001-0001.dcm.png,unknown
1627,1691_IM-0453-4001.dcm.png,there are persistent low lung volumes . there is stable streaky left lower lobe airspace disease . probable residual left pneumothorax . no large pleural effusion . stable cardiomediastinal contour . left-sided rib fractures are better appreciated on the chest comparison . 
1628,1693_IM-0454-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the lungs are hypoinflated with scarring in the left lung base . there is no focal consolidation or significant effusion . 
1629,1694_IM-0455-1001.dcm.png,the lungs are clear . the heart and pulmonary appear normal . the pleural spaces are clear . there is minimal sclerotic change overlying the midthoracic spine the lateral view . unclear whether this is a pulmonary finding or skeletal finding . bone scan would be helpful to evaluate for potential metastatic disease . the mediastinal contours are normal . 
1630,1695_IM-0456-1002001.dcm.png,"chest . the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a calcified granuloma in the left lung base . soft tissue neck . there is reversal of the normal cervical lordosis which may indicate muscle spasm versus a positional phenomenon . there is no prevertebral soft tissue xxxx . the epiglottis is within normal limits . there is a 3 mm x 1 mm density identified on the lateral exam only , possibly within one of the piriform sinuses . "
1631,1696_IM-0457-4004.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1632,1697_IM-0458-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1633,1698_IM-0458-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . "
1634,1700_IM-0462-1001.dcm.png,unknown
1635,1701_IM-0462-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1636,1702_IM-0463-1001.dcm.png,"no acute osseous abnormality . soft tissues are within normal limits . borderline enlargement of the heart . normal hilar vasculature . no focal area of consolidation , pleural effusion , or pneumothorax . "
1637,1703_IM-0463-1001.dcm.png,"lung volumes are mildly low . the cardiomediastinal silhouette is within normal limits for size contour . no consolidation . no pleural effusion or pneumothorax . mild degenerative disc change at the thoracic spine , no deformity . "
1638,1704_IM-0464-1001.dcm.png,there is blunting of the left costophrenic compatible with a moderate to large left pleural fluid collection . there are areas of airspace opacity within the left lung base which may represent atelectasis or infiltrate . minimal bandlike atelectasis within the right lung base . heart size is normal . left-sided tunneled catheter terminates at the caval atrial junction . right ij venous catheter terminates at the proximal svc . 
1639,1706_IM-0466-1001.dcm.png,cardiac silhouette and mediastinal contours are within normal limits . there are low lung volumes . there is no focal opacities . no pneumothorax . no large pleural effusion . 
1640,1707_IM-0466-1001.dcm.png,"frontal and lateral views of the chest show normal size of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
1641,1708_IM-0466-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . calcified lymph are identified in the left infrahilar region . no pneumothorax . no pleural effusion . no acute , displaced rib fractures identified . "
1642,1709_IM-0467-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is minimal opacity in the lung bases . the lungs are otherwise grossly clear . there are no acute bony findings . 
1643,1710_IM-0469-1001.dcm.png,heart size is normal . lungs are clear . no pneumothorax or pleural effusion . 
1644,1711_IM-0469-4001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . left hemidiaphragm eventration . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
1645,1712_IM-0470-3001.dcm.png,normal cardiac contours . no pleural effusion or pneumothorax . bilateral lower lobe bronchial thickening consistent with bronchitis . 
1646,1713_IM-0471-4004.dcm.png,unknown
1647,1714_IM-0472-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
1648,1716_IM-0473-1001.dcm.png,unknown
1649,1717_IM-0473-1001.dcm.png,the cardiac contours are normal . prior granulomatous disease . the lungs are clear . thoracic spondylosis . 
1650,1719_IM-0474-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size . pulmonary vasculature is within normal limits . no focal consolidations , effusions , or pneumothoraces . no acute bony abnormality . "
1651,1720_IM-0475-4004.dcm.png,there are very low lung volumes with associated central bronchovascular crowding . there is elevation of the left hemidiaphragm . there are xxxx-filled loops of mildly dilated colon in the left upper quadrant . the bowel pattern is not well evaluated secondary to incomplete imaging of the abdomen . there is no pneumothorax or definite pleural effusion . the streaky opacities in the lung bases may represent atelectasis . no definite infectious infiltrate is seen . there is scoliosis and exaggeration of the thoracic kyphosis . 
1652,1721_IM-0476-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . the patient was shielded . "
1653,1722_IM-0476-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . nodular densities projecting over the posterior 9th ribs bilaterally are consistent with nipple shadows . lungs are hyperexpanded . heart size and pulmonary vascularity within normal limits . 
1654,1723_IM-0477-1001.dcm.png,heart size is normal . there are densely calcified mediastinal and right hilar lymph which suggest prior histoplasmosis exposure . no consolidating airspace disease is seen within the lungs . no pleural effusion or pneumothorax . no convincing acute bony findings . 
1655,1724_IM-0478-1001.dcm.png,"the lungs are mildly hyperinflated , with upper lobe areas of lung lucency suggesting obstructive pulmonary disease and emphysema . no superimposed focal airspace consolidation is seen . no pleural effusion or pneumothorax . heart size is normal . "
1656,1725_IM-0478-1001.dcm.png,"there is right basilar opacity with associated blunting of the costophrenic seen on lateral view . in addition , there is a interface along the left hemidiaphragm . this may represent attenuation artifact however further evaluation with right lateral decubitus views would better evaluate . there is no pneumothorax . the lungs are clear . cardiac silhouette and mediastinal contours are within normal limits . "
1657,1726_IM-0479-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1658,1727_IM-0479-1001.dcm.png,"right-sided internal jugular central venous catheter with tip approximating the right atrium . postsurgical changes of the mediastinum including sternotomy xxxx . left base opacities again noted , stable . there is a left lung opacity , not well appreciated on prior . there is no evidence of pneumothorax . low lung volumes . degenerative changes thoracic spine . "
1659,1728_IM-0479-1001.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . there is no pneumothorax . there is no large pleural effusion . there is no focal opacity . 
1660,1729_IM-0480-1001.dcm.png,chronic bilateral emphysematous changes . the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
1661,1730_IM-0481-1001.dcm.png,"the trachea is midline . cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the bony structures reveal no acute abnormalities . lateral view reveals mild degenerative changes of the thoracic spine . "
1662,1731_IM-0481-2001.dcm.png,"low lung volumes bilaterally . the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1663,1732_IM-0482-1001.dcm.png,"cardiac and mediastinal silhouette are unremarkable . lungs are clear . no focal consolidation , pneumothorax , or pleural effusion identified . and soft tissue are unremarkable . "
1664,1733_IM-0483-0001-0001.dcm.png,unknown
1665,1734_IM-0484-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
1666,1735_IM-0484-1001.dcm.png,the trachea is midline . the cardiomediastinal silhouette is normal in size and unchanged from prior examinations with sternotomy and surgical clips overlying . there is blunting of the right costophrenic which appears unchanged from prior examination and may be secondary to scarring or pleural thickening of the right lung base . there is no evidence of acute infiltrate . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . 
1667,1736_IM-0484-1001.dcm.png,"the cardiomediastinal contours are stable and normal . mid sternotomy again noted . mildly low lung volumes . no significant pulmonary edema , focal lung consolidation , pleural effusions or pneumothorax seen . "
1668,1737_IM-0485-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
1669,1738_IM-0486-1001.dcm.png,cardiac and mediastinal contours are within normal limits . mild aortic tortuosity . the lungs are clear . bony structures are intact . 
1670,1739_IM-0487-1001.dcm.png,"there is a cortical irregularity along the anterior margin of the sternum . in addition , there is a focal retrosternal hypodense convexity . the cardiac silhouette is within normal limits . the thoracic aorta is torturous however the mediastinal contours are within normal limits . there is no pneumothorax . there is no large pleural effusion . there is streaky opacity within the left lung base representing atelectasis . otherwise , the lungs are clear . there is thoracic kyphosis . there is hyperinflation of the lungs . "
1671,1740_IM-0488-1001.dcm.png,frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . there is airspace opacity in the mid right lung radiating from the right hilum to the pleura and bordered inferiorly by the fissures . the fissure is convex upward . there is right base patchy airspace opacity . this appears chronic and may be due to scarring . there is no significant pleural effusion . 
1672,1742_IM-0489-1001.dcm.png,"heart size mildly enlarged . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . s-shaped spine curvature noted . "
1673,1743_IM-0489-4004.dcm.png,"considering differences in technical factors stable cardiomegaly and stable mediastinal contours . no focal alveolar consolidation , no definite pleural effusion seen . bronchovascular crowding without typical findings of pulmonary edema . "
1674,1744_IM-0489-2001.dcm.png,"cardiac and mediastinal silhouette are unremarkable . lungs are clear . no focal consolidation , pneumothorax , or pleural effusion identified . and soft tissue are unremarkable . "
1675,1745_IM-0489-4004.dcm.png,"frontal and lateral views of the chest show normal size cardiac silhouette , allowing for an ap projection . normal contour of the mediastinum and aorta . grossly clear lungs . no obvious pneumothorax or hemothorax . no acute displaced clavicle or rib fractures . "
1676,1746_IM-0489-1001.dcm.png,unknown
1677,1747_IM-0490-1001.dcm.png,"there is an ovoid opacity 3 . 5 cm in the retrocardiac area on ap view , not well-seen on the lateral view , a dedicated scan is recommended . no pneumothorax or pleural effusion present . the heart is normal in size . no hilar lymphadenopathy . no destructive bony lesions . "
1678,1748_IM-0490-1001.dcm.png,the heart size is normal . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
1679,1750_IM-0493-1001.dcm.png,the heart size is within normal limits . after cirrhotic calcification of the thoracic aorta . hyperexpanded lungs with flattened diaphragms and increased retrosternal clear space suggestive of emphysema . streaky left basilar opacities are favored to represent scarring . no pleural effusions or pneumothorax . exaggerated thoracic kyphosis . scattered calcified granulomas bilaterally . no acute bony abnormalities . 
1680,1751_IM-0494-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1681,1752_IM-0494-1001.dcm.png,size is normal limits . cardiomediastinal silhouette has normal contour . there is a vague opacity in the right infrahilar region . there is also a 5 mm well circumscribed nodule in the right upper lung xxxx . it is not well visualized on lateral view . 
1682,1753_IM-0494-1001.dcm.png,the heart size is persistently enlarged . lung volumes are low . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
1683,1754_IM-0494-1001.dcm.png,unknown
1684,1755_IM-0494-1001.dcm.png,unknown
1685,1756_IM-0494-1001.dcm.png,unknown
1686,1757_IM-0495-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
1687,1758_IM-0495-1001.dcm.png,the heart is normal in size . the mediastinal contours are within normal limits . there is mild prominence of the superior mediastinum which is somewhat lucent and reflects mediastinal and vascular structures . no focal consolidation is seen . there is no pleural effusion . 
1688,1759_IM-0495-1001.dcm.png,there is hyperexpansion . the heart size is normal . there is no pleural effusion or pneumothorax . two circular densities overlying the right ribs which were not present in the ct . no focal infiltrates
1689,1760_IM-0497-1001.dcm.png,mild cardiomegaly . small area of platelike atelectasis in left mid lung . no pneumothorax or pleural effusion . soft tissue and bony structures unremarkable . 
1690,1761_IM-0497-1001.dcm.png,unknown
1691,1762_IM-0497-1001.dcm.png,unknown
1692,1763_IM-0497-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures are unremarkable . stable increased lung volumes consistent with chronic lung disease . no infiltrates noted . "
1693,1764_IM-0498-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . old left rib fractures . 
1694,1765_IM-0499-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . there is rounded calcified density within the left lower lobe most consistent with granuloma . remaining lungs are clear without evidence of focal opacification . no pneumothorax or large pleural effusion . no acute bone abnormality . 
1695,1766_IM-0500-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1696,1767_IM-0501-0001-0002.dcm.png,the cardiomediastinal silhouette is within normal limits . calcified right lower lobe granuloma . no focal airspace consolidation . . no visualized pneumothorax or large pleural effusion . no acute bony abnormalities . 
1697,1768_IM-0502-12012.dcm.png,there is minimal scarring in the lung apices . the lungs are otherwise clear . heart size is normal . no pneumothorax . there is dextrocurvature within the spine . 
1698,1768_IM-0502-13013.dcm.png,there is minimal scarring in the lung apices . the lungs are otherwise clear . heart size is normal . no pneumothorax . there is dextrocurvature within the spine . 
1699,1769_IM-0503-1001.dcm.png,consolidation and some atelectasis are present in the left lower lobe . patchy interstitial infiltrates are also present in the right lower lobe . bilateral costophrenic blunting is present . heart and pulmonary are normal . 
1700,1770_IM-0504-1001.dcm.png,no pneumothorax or pleural effusion . normal cardiac contours . clear lungs bilaterally . redemonstration of transmetatarsal amputation . no evidence of acute fracture-dislocations . no evidence of any bony erosions or osseous infections . 
1701,1771_IM-0505-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1702,1773_IM-0506-1001.dcm.png,unknown
1703,1774_IM-0507-2001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours are normal . bony overlap in the lung apices could obscure a small pulmonary nodule . 
1704,1775_IM-0508-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
1705,1776_IM-0508-1001.dcm.png,heart size and mediastinal contours are stable . pulmonary vasculature is unremarkable . no focal consolidation . no visible pleural effusion or pneumothorax . no displaced rib fractures are seen . there are mild degenerative changes along the thoracic spine . 
1706,1777_IM-0509-1001.dcm.png,"the patient is rotated to left . the cardiomediastinal silhouette is normal in size . lucency along the left ventricular related to interface between the heart and aerated lung . patchy right perihilar/upper lobe opacities , which abut the fissure on lateral projection . no pneumothorax or large pleural effusion . exaggerated thoracic kyphosis . no definite acute bone abnormality . "
1707,1778_IM-0509-1001.dcm.png,unknown
1708,1779_IM-0509-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1709,1780_IM-0509-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
1710,1781_IM-0509-1001.dcm.png,heart size mediastinal contours are normal in appearance . no focal airspace consolidation . no pleural effusion or pneumothorax . mild degenerative changes of the thoracic spine . 
1711,1782_IM-0510-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . elevated right diaphragm . the lungs are clear . degenerative spondylosis . there appears to be a mildly displaced fracture of the mid right clavicle . 
1712,1783_IM-0511-2001.dcm.png,unknown
1713,1784_IM-0512-1001.dcm.png,unknown
1714,1785_IM-0512-1001.dcm.png,cardiac and mediastinal contours are within normal limits . granulomatous calcifications in the paratracheal region . mild streaky scarring in the right upper lobe . no active pneumonia . bony structures are intact . 
1715,1786_IM-0512-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . stable foreign body over the left breast ( xxxx nipple piercing ) . visualized osseous structures of the thorax are without acute abnormality . "
1716,1787_IM-0513-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild granulomatous sequela are noted . the lungs are grossly clear . 
1717,1788_IM-0513-1001.dcm.png,"the trachea is midline . negative for pneumothorax , pleural effusion , or focal airspace consolidation . the heart size is normal . "
1718,1789_IM-0513-1001.dcm.png,unknown
1719,1790_IM-0515-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1720,1791_IM-0515-1001.dcm.png,limited exam as the left costophrenic is excluded from the pa view . the heart size is normal . the mediastinal contour is within normal limits . mild lung hyperinflation . the lungs are free of any focal infiltrates . there is large calcified granuloma within the medial right lung base . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . mild multilevel degenerative changes seen within the thoracic spine . no visible acute fracture . there is no visible free intraperitoneal air under the diaphragm . 
1721,1792_IM-0515-1001.dcm.png,the heart size and mediastinal contours appear within normal limits . there are streaky left basilar opacities and blunting of the left costophrenic sulcus secondary to a small effusion . no pneumothorax . no acute bony abnormalities . 
1722,1794_IM-0515-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
1723,1795_IM-0516-1001.dcm.png,there is moderate cardiomegaly . no interstitial edema or pleural effusion . no focal airspace consolidation . no pneumothorax . there is mild degenerative disc disease of the thoracic spine . 
1724,1796_IM-0517-1002.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1725,1797_IM-0517-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . small t-spine osteophytes . 
1726,1798_IM-0518-1001.dcm.png,unknown
1727,1799_IM-0519-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or pleural effusion . 
1728,1800_IM-0520-1001.dcm.png,"lungs are hyperexpanded bilaterally , with no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
1729,1801_IM-0520-1001.dcm.png,stable mild cardiomegaly . mediastinal contours are unchanged . lungs are clear without focal consolidation . no visible pleural effusion or pneumothorax . 
1730,1802_IM-0521-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
1731,1803_IM-0521-1001.dcm.png,unknown
1732,1803_IM-0521-1003.dcm.png,unknown
1733,1804_IM-0522-82050001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . there is a right chest with central venous catheter tip overlying the high svc . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . "
1734,1805_IM-0523-1001.dcm.png,unknown
1735,1807_IM-0524-1001.dcm.png,the heart is mild enlarged . central pulmonary vascularity is again accentuated . there are also mild increased interstitial markings without focal consolidation or pleural effusion . 
1736,1808_IM-0524-1001.dcm.png,"the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of a pleural effusion . there is no evidence of pneumothorax . multilevel flowing anterior thoracic spine osteophytes , which could represent changes of diffuse idiopathic skeletal hyperostosis ( dish ) . "
1737,1809_IM-0524-1001.dcm.png,unknown
1738,1810_IM-0524-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
1739,1811_IM-0525-1001.dcm.png,"there is mild cardiomegaly and tortuous aorta . mildly low lung volumes . no focal consolidation , pleural effusion , or pneumothorax . the are intact and without acute osseous abnormality . mild degenerative changes of the thoracic spine . "
1740,1812_IM-0525-1001.dcm.png,"no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . heart size and pulmonary vascularity within normal limits , visualized osseous structures appear intact . "
1741,1813_IM-0526-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . lung volumes are low normal . there are no acute bony findings . "
1742,1814_IM-0527-1001.dcm.png,unknown
1743,1815_IM-0527-1001.dcm.png,there is no focal consolidation . there is no pneumothorax or large pleural effusion . the cardiomediastinal contours are grossly unremarkable . the heart size is within normal limits . there are mild thoracic spine degenerative changes . 
1744,1816_IM-0528-1001.dcm.png,the heart and mediastinum are unremarkable . again identified are numerous calcified mediastinal lymph as well as large calcifications within the left upper and left lower lobes . these appear similar to the patient's previous chest ct and are the sequela of prior granulomatous disease . the lungs are otherwise clear without infiltrate . there is no effusion or pneumothorax . 
1745,1817_IM-0529-4004.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . upper thorax is poorly visualized due to patient's overlying head and chin . the cardiomediastinal contours are within normal limits . background of mild coarse interstitial opacities seen throughout the lungs related to background of emphysema . calcified granuloma is seen in the left medial lung base . there is no consolidation , pleural effusion or pneumothorax . deformity of the right 6th rib laterally has appearance of acute or subacute fracture . degenerative changes of the thoracic spine are again seen . "
1746,1818_IM-0530-4004.dcm.png,unknown
1747,1819_IM-0530-1001-0001.dcm.png,unknown
1748,1820_IM-0532-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . eventration of the right hemidiaphragm . no focal lung consolidation , pleural effusion or pneumothorax . no acute bony abnormality . "
1749,1821_IM-0532-1003.dcm.png,"the heart and mediastinum are normal in size and contour . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are degenerative changes in the thoracic spine . "
1750,1822_IM-0533-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . no focal air space disease . prominent hilar xxxx . no large pleural effusion or pneumothorax . the are intact . 
1751,1823_IM-0534-1001.dcm.png,"chest . heart size is normal . pulmonary vasculature is normal . there is a 13 mm nodule in the right lower lobe that is relatively dense , but not obviously calcified on the corresponding rib series . there are probably right hilar calcified lymph xxxx . lungs otherwise are clear . there is no pleural effusion . left ribs . no fracture or focal bony destruction . "
1752,1824_IM-0535-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1753,1825_IM-0535-1001.dcm.png,unknown
1754,1826_IM-0535-0001.dcm.png,"the central airway is midline and is xxxx . the cardiomediastinal silhouette is within normal limits . there is no focal lung consolidation , pleural effusion , or pneumothorax seen . the osseous structures appear within normal limits . "
1755,1827_IM-0535-1001.dcm.png,the cardiopulmonary silhouette is normal . the heart size is normal . the lungs are clear with no pulmonary effusions or pneumothorax . 
1756,1828_IM-0536-1001.dcm.png,unknown
1757,1829_IM-0537-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette and mediastinal contours are not enlarged . removal of 2 left-sided chest tubes . there is no pneumothorax . lungs demonstrate no acute findings . there is minimal posterior pleural effusions . 
1758,1831_IM-0538-2001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
1759,1832_IM-0538-1001.dcm.png,interval removal of cardiac generator . cardiomegaly . left base streaky opacities again noted . no large focal areas of consolidation . no pleural effusions . osseous structures intact . no pneumothorax . 
1760,1833_IM-0539-1001.dcm.png,there is a small area of scarring or atelectasis in the left base . calcified granulomas seen in the posterior right lower lobe . lungs are otherwise clear . the heart and mediastinum are normal . the skeletal structures and soft tissues are normal . 
1761,1834_IM-0539-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1762,1835_IM-0539-1001.dcm.png,low lung volumes . the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
1763,1836_IM-0540-2002.dcm.png,the heart is top normal in size . the mediastinum is stable . aorta is tortuous and atherosclerotic . lungs are mildly hypoinflated . no acute infiltrate is seen . 
1764,1837_IM-0541-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1765,1839_IM-0543-12013.dcm.png,the heart is normal in size . the mediastinum is stable . granulomatous sequela are noted . the previously visualized nodular density in the right upper lobe is not well-seen on today's study . there is no acute infiltrate or pleural effusion . 
1766,1840_IM-0545-1001.dcm.png,pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . there is asymmetric opacity to left suprahilar chest . no discrete correlate is seen on lateral view . findings may reflect focal airspace disease or adenopathy . no pleural effusion . no pneumothorax . 
1767,1841_IM-0545-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1768,1842_IM-0545-1001.dcm.png,unknown
1769,1843_IM-0546-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1770,1844_IM-0547-1001.dcm.png,"normal cardiomediastinal contours . hyperexpansion of the lungs with flattening of the diaphragm . no focal lung consolidation , pneumothorax or pleural effusions . "
1771,1845_IM-0548-4004.dcm.png,unknown
1772,1846_IM-0549-3001.dcm.png,"2 images . calcified granuloma left upper lobe . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1773,1847_IM-0550-1001.dcm.png,"the cardiac and mediastinal silhouettes are unremarkable . the lungs are well expanded and clear . there is no focal air space opacity , pneumothorax , or effusion . there are large calcified mediastinal and right hilar granulomas . the bony structures of the thorax are intact with no evidence of acute abnormality . "
1774,1848_IM-0550-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . there are small round calcific density nodules consistent with prior granulomatous disease bilaterally . otherwise , the lungs are clear without evidence of acute infiltrate or effusion . there are no masses seen . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
1775,1849_IM-0550-1001.dcm.png,heart size is within normal limits . 8mm calcified granuloma in the right base . no focal airspace consolidations . no pneumothorax or effusion . 
1776,1851_IM-0553-1001.dcm.png,heart size is normal . no focal airspace consolidations . no pneumothorax or effusion . no acute osseous findings . 
1777,1852_IM-0554-1001.dcm.png,"lungs are clear . no focal consolidation , effusion , or pneumothorax . heart and mediastinal contours are normal . osseous structures intact . "
1778,1853_IM-0555-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1779,1854_IM-0555-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
1780,1855_IM-0555-1001.dcm.png,heart size within normal limits . there is focal left lateral base airspace disease . there is a 6 mm nodular opacity in the right midlung . no pneumothorax . no pleural effusion . no displaced rib fractures . there is an apparent deformity of the right humeral surgical neck . this is not seen on the comparison . correlate clinically with history of fracture . 
1781,1856_IM-0556-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
1782,1857_IM-0556-4004.dcm.png,mild cardiomegaly . normal size and mediastinal contours . clear lungs . no pneumothorax or pleural effusion . unremarkable xxxx . 
1783,1859_IM-0557-12001.dcm.png,unknown
1784,1860_IM-0558-1001.dcm.png,the cardiac and mediastinal silhouettes are normal . the lungs are well-expanded and clear . there is no focal airspace opacity . there is no pneumothorax or effusion . there is dextrocurvature of the thoracic spine . there is deformity of the t9 vertebral body . levocurvature of the lumbar spine with significant degenerative change is also noted . 
1785,1861_IM-0558-1001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . 
1786,1863_IM-0558-1001.dcm.png,heart size is mildly enlarged . tortuous aorta . lung volumes are low with central bronchovascular crowding and patchy basilar atelectasis . . degenerative changes of the spine . 
1787,1864_IM-0558-1001.dcm.png,"heart size borderline enlarged . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . dense nodule in the right lower lobe suggests a previous granulomatous process . "
1788,1865_IM-0558-2001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . calcified right upper lobe pulmonary granuloma and calcified right hilar lymph xxxx . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
1789,1866_IM-0559-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1790,1867_IM-0560-4004.dcm.png,cardiomegaly and tortuous calcified thoracic aorta are unchanged . normal pulmonary vascularity . minimal streaky bibasilar opacities . blunted left costophrenic xxxx . bony demineralization . degenerative changes of the spine . verterbroplasty change near the thoracolumbar junction . upper abdominal surgical changes . chronic appearing deformity of the proximal right humerus . old right rib fractures . 
1791,1868_IM-0561-1001.dcm.png,heart size and pulmonary vascularity normal . there is a small right pleural effusion . there is infrahilar interstitial prominence which may represent bronchovascular crowding lung . small left pleural effusion . no pneumothorax . 
1792,1870_IM-0563-1001.dcm.png,there is marked cardiomegaly . there is questionable dilation of the pulmonary arteries . low lung volumes . no focal airspace consolidation . no pleural effusion or pneumothorax . prominent interstitial markings are due to low lung volumes . elevated right hemidiaphragm . 
1793,1871_IM-0564-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is identified . 
1794,1872_IM-0565-1001.dcm.png,no pneumothorax or pleural effusion . clear lungs bilaterally . normal cardiac contours . multiple anterior endplate osteophyte formation along thoracic spine . 
1795,1873_IM-0565-1001.dcm.png,"cardiomediastinal silhouette is within normal limits . no focal consolidation , pneumothorax , or pleural effusion . no acute bony abnormalities . degenerative changes of the thoracic spine . "
1796,1874_IM-0565-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is a thin right apical pneumothorax measuring approximately 5 mm in thickness . there is extensive subcutaneous emphysema in the right chest wall and neck . there are fractures of the right anterior 5th through 9th anterior ribs with mild displacement . additional fractures cannot entirely be excluded . there is mild streaky airspace disease in the right lung base . left lung is clear . there is a small hiatal hernia . there is an intrathecal catheter terminating in the lower thoracic spine . 
1797,1875_IM-0566-2001.dcm.png,heart size and mediastinal contour are normal . mild tortuosity of the aorta . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
1798,1876_IM-0567-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . right apical pleural retraction . hyperexpansion , flattening of diaphragms , and increased ap diameter consistent with history of copd . degenerative disease of the thoracic spine is present . "
1799,1877_IM-0568-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1800,1878_IM-0569-1001.dcm.png,and lateral chest examination was obtained . calcified granuloma seen . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
1801,1879_IM-0569-1001.dcm.png,heart size within normal limits . no focal airspace disease . no cavitations . no pneumothorax or pleural effusion . 
1802,1880_IM-0569-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is an 8mm nodule identified within the left lateral midlung partially overlying the posterior left 7th rib . there are mild degenerative changes of the spine . "
1803,1881_IM-0570-3001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . aortic atherosclerosis . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
1804,1882_IM-0571-1001.dcm.png,clear lungs bilaterally . normal cardiac contours . no pneumothorax or pleural effusion . 
1805,1883_IM-0572-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . there are right upper quadrant surgical clips , perhaps from cholecystectomy . "
1806,1884_IM-0573-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is noted . degenerative changes are noted in the spine . the descending thoracic aorta is mildly tortuous . the mediastinum appears somewhat prominent . 
1807,1885_IM-0574-1001.dcm.png,"heart size is normal . mediastinal contour and pulmonary vascularity within normal limits . no focal airspace consolidation , pneumothorax , or pleural effusion . no acute bony abnormality . "
1808,1886_IM-0574-1001.dcm.png,"heart size and mediastinal contour within normal limits . atherosclerotic calcification within the aorta . calcified granulomas in bilateral and overlying the t9 vertebral body ( lateral view ) . no focal airspace consolidation , pneumothorax , or large pleural effusion . degenerative changes of thoracic spine . no acute osseous abnormality . "
1809,1887_IM-0575-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . scoliosis and arthritic changes of the skeletal structures are noted . there is increased kyphosis of the thoracic spine similar to the prior study
1810,1888_IM-0576-4004.dcm.png,cardiomediastinal contours are unchanged . there are stable fractures of several xxxx . lungs are hyperexpanded but clear . no pneumothorax or pleural effusion . degenerative changes are seen in the spine . 
1811,1889_IM-0577-1001.dcm.png,"stable cardiomediastinal silhouette . elevated right hemidiaphragm . atelectasis in the right lung base . no focal pulmonary consolidation , pleural effusion or pneumothorax . no acute bony abnormality . degenerative changes of the thoracic spine . "
1812,1891_IM-0580-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1813,1892_IM-0580-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . stable right lower lobe calcified granuloma . no focal consolidation , pneumothorax or large pleural effusion . spurring of the thoracic spine . "
1814,1893_IM-0580-1001.dcm.png,mildly low lung volumes . lungs are clear without focal air space disease . persistent mild elevation right hemidiaphragm . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
1815,1894_IM-0581-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . subtle increased opacity of right mid hemithorax related to superimposed soft tissues . the lungs are otherwise clear . there is no pleural effusion or pneumothorax . 
1816,1895_IM-0581-1001.dcm.png,"the lateral images limited secondary to motion artifact . no focal consolidation , large pneumothorax or large pleural effusion . heart size normal . unremarkable . "
1817,1896_IM-0581-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1818,1897_IM-0581-1001.dcm.png,the heart is normal in size . the mediastinum is within normal limits . pectus deformity is noted . left ij dual-lumen catheter is visualized without pneumothorax . the lungs are clear . 
1819,1898_IM-0581-1001.dcm.png,"the aortic xxxx , cardiac apex , and stomach are left-sided . the cardiomediastinal silhouette is significantly enlarged . pulmonary vascular markings centrally are within normal limits and symmetric . increased interstitial markings bilaterally at the lung bases . this may be related to chronic interstitial changes or edema . no focal airspace disease . no pleural effusion or pneumothorax . no acute bony abnormality . "
1820,1899_IM-0582-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1821,1900_IM-0584-1001.dcm.png,"there are sternotomy identified . the heart is within normal limits in size . the aorta is calcified and tortuous . there are scattered calcified granulomas throughout both lungs . no focal infiltrate , pleural effusion , or pneumothorax . mild degenerative changes of the thoracic spine . "
1822,1901_IM-0585-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . there has been interval cabg . surgical clips are again seen in the epigastric region . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures are unremarkable . "
1823,1902_IM-0586-1001.dcm.png,"normal and stable cardiomediastinal contours . no pneumothorax , pleural effusions or significant pulmonary edema . no focal lung consolidation . "
1824,1903_IM-0586-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the lungs are clear . 
1825,1904_IM-0586-1001.dcm.png,unknown
1826,1905_IM-0587-1001.dcm.png,"enlarged cardiac contour , stable . calcified vasculature . sequelae of prior granulomatous disease . no confluent consolidation , pleural effusion , or overt pulmonary edema . mild thoracic spondylosis . "
1827,1906_IM-0588-4004.dcm.png,unknown
1828,1907_IM-0589-1001.dcm.png,unknown
1829,1908_IM-0590-1001.dcm.png,"cardiac silhouette and mediastinal contours are within normal limits . nodular opacity overlying the upper lungs bilaterally may represent overlying telemetry xxxx , correlate clinically . otherwise , lungs are clear . no large pleural effusion no pneumothorax . "
1830,1909_IM-0590-1001.dcm.png,"consolidation , atelectasis , and costophrenic blunting in the left lower lobe have cleared in the interval . a persistent patchy infiltrate is present in the right middle lobe . no infiltrates . heart is slightly large . pulmonary are normal . aorta remains tortuous . "
1831,1910_IM-0592-2001.dcm.png,unknown
1832,1911_IM-0593-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . "
1833,1912_IM-0594-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1834,1913_IM-0595-1001.dcm.png,"the heart size and cardiopulmonary silhouette is normal . there is no focal airspace opacity , pleural effusion , or pneumothorax . the obstruction are intact with mild degenerative change in the thoracic spine . "
1835,1914_IM-0595-1001.dcm.png,stable heart size . diffuse bilateral interstitial opacities . no pneumothorax . no effusions . no acute bony abnormalities . 
1836,1915_IM-0595-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
1837,1916_IM-0595-1001.dcm.png,there is stable left costophrenic blunting . the patient has undergone prior left lobectomy . there are chronic appearing right basilar interstitial markings . heart size normal . no visualized pneumothorax . there is stable appearing left upper and right upper lobe bullous disease . 
1838,1918_IM-0597-2001.dcm.png,"there is a 1 . 5 cm nodular opacity projecting over left hilum . the cardiac silhouette is within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of pleural effusion . there is no evidence of pneumothorax . opacities representing surgical clips , in the midline at the level of the thoracic inlet . "
1839,1919_IM-0598-1001.dcm.png,"hyperexpansion of the lungs with hyperlucency and flattening of hemidiaphragms suggestive of chronic emphysematous lung disease . heart size within normal limits . bibasilar , right greater than left atelectasis/airspace disease noted . no pneumothorax or large pleural effusion . no acute bony abnormality . "
1840,1919_IM-0598-3001.dcm.png,"hyperexpansion of the lungs with hyperlucency and flattening of hemidiaphragms suggestive of chronic emphysematous lung disease . heart size within normal limits . bibasilar , right greater than left atelectasis/airspace disease noted . no pneumothorax or large pleural effusion . no acute bony abnormality . "
1841,1920_IM-0598-1001.dcm.png,"cardiomediastinal silhouette is normal in size and contour . pulmonary vasculature is normal in caliber . lungs are clear of focal airspace disease , pneumothorax or pleural effusion . there are no acute bony findings . "
1842,1921_IM-0598-1001.dcm.png,"redemonstration of moderately-inflated lungs , consistent with copd and unchanged . atherosclerotic calcifications of the thoracic seen . no airspace disease , effusion or noncalcified nodule . normal heart size and mediastinum . visualized of the chest are within normal limits . "
1843,1922_IM-0598-1001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures and lung are unremarkable . "
1844,1923_IM-0598-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . hyperinflated lungs . cardiomegaly . bony thorax and soft tissues grossly unremarkable"
1845,1924_IM-0598-4004.dcm.png,"rotated apical lordotic frontal projection , mild bronchovascular crowding and scattered chronic appearing irregular interstitial markings . no definite focal alveolar consolidation or pleural effusion seen . accounting for technical factors heart size within normal limits , heavily calcified and mildly tortuous aorta . no typical findings of pulmonary edema . "
1846,1925_IM-0599-1001.dcm.png,the heart is normal in size . there is bihilar prominence . the lungs are clear . 
1847,1926_IM-0600-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
1848,1927_IM-0600-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are otherwise clear . bony structures are intact . 
1849,1928_IM-0600-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1850,1929_IM-0600-1001.dcm.png,fracture deformity proximal right humerus . hyperinflation lungs . no pulmonary consolidation . opacity left base compatible atelectasis or scarring . the cardiomediastinal silhouette appears unremarkable . mild atherosclerotic calcification aorta . prior chest surgery . costophrenic clear . visualized spine vertebrae appear normal in and alignment . 
1851,1930_IM-0602-1001-0002.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are mildly hypoinflated but grossly clear of focal airspace disease , pneumothorax , or pleural effusion . there are mild degenerative endplate changes in the thoracic spine . there are no acute bony findings . "
1852,1931_IM-0602-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1853,1932_IM-0603-2001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
1854,1933_IM-0604-1001.dcm.png,"aorta is ectatic . heart size is within normal limits . no focal consolidation , pneumothorax or pleural effusion . age-indeterminate anterior wedging deformity of lower thoracic vertebra . "
1855,1934_IM-0604-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is chronic left hemidiaphragm elevation . the aorta is tortuous and ectatic with atherosclerotic calcifications . "
1856,1935_IM-0605-0001-0001.dcm.png,the heart is borderline in size . the aorta is mildly tortuous . right ij catheter is in with tip in proximal right atrium/cavoatrial junction . there is no pneumothorax . lungs are grossly clear . there is no large effusion . 
1857,1936_IM-0606-1001.dcm.png,"a right internal jugular this catheter has been exchanged for a large left internal jugular central venous catheter with the tip at the cavoatrial junction . no pneumothorax , pleural effusion or airspace consolidation . stable thoracolumbar scoliosis . no acute bone findings . stable cardiomegaly . "
1858,1937_IM-0607-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
1859,1938_IM-0608-1001.dcm.png,"no focal lung opacity , pleural effusion or pneumothorax . cardiomediastinal silhouette is unremarkable . "
1860,1939_IM-0609-1001.dcm.png,lungs are clear . heart size normal . no pneumothorax . left costophrenic opacity may represent pleural or pericardial fat . 
1861,1940_IM-0610-2002.dcm.png,postsurgical changes noted overlying the left axilla . no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . 
1862,1943_IM-0612-1001.dcm.png,heart size normal . mediastinum unremarkable . pulmonary vascularity within normal limits . lungs symmetrically aerated without focal infiltrate or consolidation . multiple scattered calcified granulomas are present bilaterally . no focal volume loss evident . no pneumothorax or pleural effusion . bony thorax unremarkable . 
1863,1944_IM-0613-1001.dcm.png,unknown
1864,1946_IM-0615-1001.dcm.png,"portable frontal view of the chest with overlying external cardiac monitor leads shows normal cardiomediastinal silhouette , central airways , pulmonary vasculature and lung volumes without focal air space consolidation or pleural effusion . "
1865,1947_IM-0616-1001.dcm.png,"heart size within normal limits , stable mediastinal contours . no focal alveolar consolidation , no definite pleural effusion seen . a dense nodule in the right base suggests a previous granulomatous process . no typical findings of pulmonary edema . no pneumothorax . "
1866,1948_IM-0616-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
1867,1949_IM-0617-0001.dcm.png,unknown
1868,1949_IM-0617-1001.dcm.png,unknown
1869,1950_IM-0618-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . "
1870,1951_IM-0619-1001.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are unchanged . "
1871,1953_IM-0621-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
1872,1954_IM-0622-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1873,1956_IM-0623-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is identified . 
1874,1957_IM-0624-4004.dcm.png,"bilateral pleural effusions , left small , right moderate in size , abnormal opacities in the adjacent lung bases . limited assessment of heart size due to obscured margins , stable mediastinal contours . "
1875,1958_IM-0625-1001.dcm.png,the lungs are hyperaerated suggestive of chronic obstructive pulmonary disease . no focal lung consolidation . no pleural effusion . no definite pneumothorax . heart is not enlarged . postsurgical changes with mediastinal clips and xxxx . 
1876,1959_IM-0625-1001.dcm.png,"normal heart size . normal mediastinal silhouette . no pneumothorax , pleural effusion or suspicious focal air space opacity . prior granulomatous disease appears stable . "
1877,1960_IM-0627-1002001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
1878,1961_IM-0628-3001.dcm.png,"stable cardiomegaly with significantly low lung volumes and associated bronchovascular crowding and bibasilar atelectasis . no definite pleural effusion , consolidation , or pneumothorax identified . no acute bony abnormality . "
1879,1962_IM-0628-2002.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . stable right lower lung granuloma . interval to right clavicle procedure . heart size and pulmonary vasculature appear within normal limits . are intact . "
1880,1963_IM-0629-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
1881,1964_IM-0629-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1882,1965_IM-0629-1001.dcm.png,"there is moderate cardiomegaly . there are bilateral interstitial opacities , increased since the previous exam . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
1883,1966_IM-0629-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1884,1967_IM-0629-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . there has been interval development of some bandlike opacities in left base . these appear to be located in the lingula . the remainder of the lungs appear clear . no pneumothorax or pleural effusion is seen . 
1885,1968_IM-0630-4004.dcm.png,the lateral view is nondiagnostic due to patient positioning . normal heart size and mediastinal contours . no focal airspace consolidation . no pneumothorax or large pleural effusion . visualized osseous structures are unremarkable in appearance . 
1886,1969_IM-0630-1001.dcm.png,unknown
1887,1970_IM-0632-1001.dcm.png,"apparent cardiomegaly at partially accentuated by low lung volumes . no focal consolidation , pneumothorax or large pleural effusion . right base calcified granuloma . stable right infrahilar nodular density ( lateral view ) . negative for acute bone abnormality . "
1888,1971_IM-0633-1001.dcm.png,unknown
1889,1972_IM-0633-1001.dcm.png,there is a airspace opacity in the left upper lung . heart size within normal limits . mild calcification of the aortic xxxx . no pneumothorax or pleural effusions . 
1890,1973_IM-0633-1001.dcm.png,"cardiomediastinal silhouette is within normal limits for size , with redemonstration of tortuous and atherosclerotic calcified thoracic aorta . no focal consolidation , effusion , or pneumothorax identified . eventration of the right hemidiaphragm is stable compared to prior examination . multilevel degenerative disc disease and thoracolumbar spine again noted without acute osseous abnormality . "
1891,1974_IM-0633-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
1892,1975_IM-0634-1001.dcm.png,unknown
1893,1975_IM-0634-3001.dcm.png,unknown
1894,1976_IM-0635-1001-0001.dcm.png,unknown
1895,1976_IM-0635-1001-0002.dcm.png,unknown
1896,1976_IM-0635-1001-0003.dcm.png,unknown
1897,1977_IM-0636-1001.dcm.png,unknown
1898,1978_IM-0636-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . cholecystectomy clips are present . 
1899,1979_IM-0637-1001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . 
1900,1980_IM-0637-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
1901,1981_IM-0638-3001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . chronic degenerative changes are present within the spine . "
1902,1982_IM-0639-1001.dcm.png,unknown
1903,1983_IM-0640-2002.dcm.png,unknown
1904,1984_IM-0641-4001-0001.dcm.png,"heart size and mediastinal contour are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . again visualized is a wedge-shaped fracture of t12 . "
1905,1985_IM-0642-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
1906,1986_IM-0643-1001.dcm.png,"the heart size and cardia mediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion , or pneumothorax . there is an approximately 8mm opacity overlying the sixth anterior rib . there are other scattered calcified granulomas . the osseous structures are intact . there are mild degenerative changes in the thoracic spine . "
1907,1987_IM-0644-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1908,1988_IM-0645-1001.dcm.png,unknown
1909,1990_IM-0648-1001.dcm.png,"pa and lateral views of the chest were obtained . tracheostomy tube . probable mild cardiomegaly . prominence of the central vasculature , unchanged . no pneumothorax pleural effusion or focal consolidation . "
1910,1991_IM-0648-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the lungs are hypoinflated . there are streaky opacities predominantly in the left lung base possibly related to scarring and atelectasis . b-lines are also noted . definite infiltrate is not excluded . there is no large effusion . 
1911,1992_IM-0649-4004.dcm.png,borderline heart size . the lungs are hyperexpanded and hyperlucent compatible with chronic obstructive pulmonary disease . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are unchanged . aortic vascular calcifications . normal pulmonary vascularity . bone demineralization . 
1912,1993_IM-0650-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . hyperexpanded lungs . normal heart size . bony thorax and soft tissues grossly unremarkable . "
1913,1994_IM-0651-1001.dcm.png,lungs are clear . no pneumothorax or pleural effusion . normal heart and mediastinal contours . normal pulmonary vasculature . bony thorax intact . 
1914,1995_IM-0651-1001.dcm.png,"the lungs are clear , and without focal air space opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax or large pleural effusion . "
1915,1997_IM-0651-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1916,1999_IM-0651-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
1917,2000_IM-0654-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1918,2001_IM-0654-8001.dcm.png,unknown
1919,2002_IM-0654-1001.dcm.png,within the posterior lateral 8th rib there is a deformity along the cortex with associated oblique lucency . in addition within the posterior lateral 9th rib there appears to be a obliquely oriented lucency with cortical disruption . findings are concerning for possible left rib fractures . otherwise the cardiomediastinal silhouette is within normal limits . the lungs are clear bilaterally . multiple small punctate radiopaque foreign bodies are seen within the subcutaneous tissues and are present on previous ct scan from xxxx . 
1920,2003_IM-0654-2001.dcm.png,"borderline enlarged heart . pulmonary vasculature appears within normal limits . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . possible right shoulder calcific tendinitis . calcifications of the abdominal aorta are seen . "
1921,2005_IM-0656-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1922,2006_IM-0656-1001.dcm.png,heart size is mildly enlarged . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a calcified granuloma in the right lung base . there are mild degenerative changes of the spine . there are some chronic increased interstitial markings noted . 
1923,2007_IM-0657-0001-0002.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . the mediastinal contours are normal . there are mild degenerative changes of the thoracic spine . 
1924,2008_IM-0658-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no pleural effusions . heart size normal . the cardiomediastinal silhouette is unremarkable . 
1925,2010_IM-0661-1001.dcm.png,unknown
1926,2011_IM-0661-1001.dcm.png,"cardiomediastinal silhouette is within normal limits . no focal consolidation . no pneumothorax or large pleural effusion . no acute bony abnormalities . contrast is seen within the bilateral kidneys , from prior examination . "
1927,2012_IM-0662-3001.dcm.png,normal cardiomediastinal contours . lungs are clear bilaterally . no pneumothorax or pleural effusion . 
1928,2013_IM-0663-1001.dcm.png,heart size within normal limits . mild left upper lobe atelectasis or scarring . no pneumothorax or pleural effusion . tortuous aorta . hiatal hernia . 
1929,2014_IM-0664-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . no focal airspace consolidation or pleural effusion . there is subphrenic intraperitoneal extraluminal free xxxx . "
1930,2015_IM-0664-2001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
1931,2016_IM-0665-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
1932,2017_IM-0665-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
1933,2018_IM-0665-1001.dcm.png,unknown
1934,2019_IM-0666-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
1935,2020_IM-0668-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
1936,2021_IM-0668-1001.dcm.png,"stable borderline cardiomegaly , stable mediastinal and hilar contours . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . "
1937,2022_IM-0669-1001.dcm.png,the heart and lungs have in the interval . both lungs are free of acute infiltrates and expanded . strandy scarring in the left lower lobe is unchanged . heart and mediastinum normal . 
1938,2023_IM-0669-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
1939,2024_IM-0670-1001.dcm.png,unknown
1940,2026_IM-0671-1001.dcm.png,"the trachea is midline . cardiomediastinal silhouette is normal . the lungs are clear , without evidence of focal consolidation or pleural effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
1941,2027_IM-0672-0001-0002.dcm.png,heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . in the left midlung zone there is identified a 1 . 5 cm nodule . this appears somewhat dense and may contain calcium although this cannot be stated with certainty . 
1942,2028_IM-0673-1001.dcm.png,heart size is normal . no focal airspace disease . no pneumothorax or effusion . 
1943,2029_IM-0674-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . the visualized osseous structures are unremarkable in appearance . 
1944,2030_IM-0675-1001.dcm.png,there is hyperinflation lungs due to small calcification is seen posteriorly in the right which may be pleural . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
1945,2031_IM-0676-2002.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . no pulmonary nodules identified . "
1946,2032_IM-0677-1001.dcm.png,the lungs are clear . no focal air space consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . 
1947,2033_IM-0678-1001.dcm.png,"the cardiac silhouette is near upper limits of normal in size . pulmonary vasculature is normal in caliber . there is mild tortuosity of the descending thoracic aorta . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . there are mild degenerative endplate changes in the thoracic spine . "
1948,2034_IM-0679-2001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . opacities in the right lower lung representing atelectasis versus scarring . significantly decreased subcutaneous soft tissue since comparison radiograph . probable pectus deformity . negative for acute bony abnormality . 
1949,2035_IM-0680-1001.dcm.png,hyperexpanded lungs suggesting obstructive lung disease . sequelae of old granulomatous disease . no focal airspace disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
1950,2036_IM-0680-4001.dcm.png,"there is mild cardiomegaly . the thoracic aorta is tortuous . lung volumes are low with asymmetric elevation of the right hemidiaphragm . there is platelike atelectasis in the right midlung along with bibasilar airspace disease , either atelectasis or infiltrate . no pneumothorax . "
1951,2038_IM-0682-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion or pneumothorax . the osseous structures are intact . "
1952,2039_IM-0683-1001.dcm.png,cardiac and mediastinal contours are within normal limits . large calcified granulomas in the right hilum . the lungs are otherwise clear . prior anterior cervical fusion . 
1953,2040_IM-0684-1001.dcm.png,unknown
1954,2041_IM-0685-1001.dcm.png,no pneumothorax . no large pleural effusions . heart size is normal . no acute focal space opacities . 
1955,2041_IM-0685-3001.dcm.png,no pneumothorax . no large pleural effusions . heart size is normal . no acute focal space opacities . 
1956,2042_IM-0686-1001.dcm.png,unknown
1957,2043_IM-0686-2001.dcm.png,unknown
1958,2044_IM-0687-1001.dcm.png,low lung volumes with bronchovascular crowding at the bases . no focal opacity . no pneumothorax . no large pleural effusion . cardiac silhouette mediastinal contours within normal limits . 
1959,2045_IM-0687-1001.dcm.png,the heart is upper limits of normal in size . mild tortuosity of the thoracic aorta . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
1960,2046_IM-0688-1001.dcm.png,there is a minimally displaced fracture of the right lateral 7th rib . there is a small right pleural effusion with associated atelectasis of the right lower lobe . there appears to be a healing fracture of the posterolateral right 8th rib . there is questionable cortical defect involving the sternum seen on lateral view . would be to evaluate this finding . as the small right-sided pleural effusion is visible on both pa and lateral views . there is a left-sided pleural effusion as well . the left lung appears grossly clear . heart size and pulmonary appear normal . there is a mild scoliosis involving the thoracic spine . 
1961,2047_IM-0688-1001.dcm.png,large calcified granuloma in the right lower lobe is unchanged . no pneumothorax . heart size is normal . no large pleural effusions . no focal airspace opacification . 
1962,2048_IM-0688-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . stable right lower lobe calcified granulomas . thin lingular scar , unchanged . heart size and pulmonary vascularity within normal limits . surgical clips are visualized in the right upper quadrant . "
1963,2049_IM-0688-2001.dcm.png,unknown
1964,2050_IM-0690-1001.dcm.png,unknown
1965,2052_IM-0690-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . scattered granulomatous changes . mild unfolding of the thoracic aorta . bony thorax is unremarkable"
1966,2053_IM-0691-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
1967,2054_IM-0692-0001-0002.dcm.png,unknown
1968,2055_IM-0693-1001.dcm.png,unknown
1969,2056_IM-0694-1001-0002.dcm.png,the heart size is upper limits of normal . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . 
1970,2058_IM-0696-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are mildly hypoinflated but clear . 
1971,2059_IM-0696-1001.dcm.png,right lower lobe patchy opacities noted . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . mild degenerative changes of the thoracic spine . 
1972,2060_IM-0698-1001.dcm.png,there is prominence of the left hilum which may represent adenopathy or engorged vasculature . cardiac silhouette is within normal limits of size and contour . no pneumothorax or large pleural effusion . no acute bone abnormality . 
1973,2061_IM-0698-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
1974,2062_IM-0699-0001-0001.dcm.png,"right subclavian catheter , distal tip posterior to the head of the clavicle , the level of the subclavian vein . low lung volumes . no pleural effusion . left lower lobe airspace disease , atelectasis . cardiomediastinal size is within normal limits . pulmonary vasculature is normal . intact . "
1975,2063_IM-0700-1001.dcm.png,unknown
1976,2065_IM-0701-1001.dcm.png,"stable cardiomediastinal silhouette . no focal airspace consolidation , suspicious pulmonary opacity , pneumothorax , or pleural effusion . changes of right mastectomy . sequelae of prior granulomatous disease . mild thoracic spine degenerative change"
1977,2066_IM-0701-1001.dcm.png,"there is mild cardiomegaly . the aorta is tortuous . there is opacities noted in the right lower lobe , subsegmental atelectasis . there is no pneumothorax or effusion . no displaced rib fractures . if there is high clinical concern , consider dedicated rib views for further evaluation . "
1978,2067_IM-0701-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
1979,2068_IM-0701-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
1980,2069_IM-0702-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
1981,2070_IM-0704-1001.dcm.png,"there are no acute osseous abnormalities . questionable old left posterior third and fourth rib fractures . visualized soft tissues are within normal limits . normal heart size . normal hilar vascular markings . subtle prominence of interstitial markings in the bases , left worse than right . no focal area of consolidation , pleural effusion , or pneumothorax . "
1982,2072_IM-0706-1001.dcm.png,"stable , nonenlarged cardiomediastinal silhouette . left upper lobe calcified granuloma noted . epigastric and right upper quadrant postsurgical changes . interval increased bilateral interstitial opacities , with probable left lower lobe infiltrate . "
1983,2073_IM-0707-1001.dcm.png,unknown
1984,2074_IM-0708-1001.dcm.png,low lung volumes . stable ectasia of the thoracic aorta . stable right upper mediastinal bilateral small pleural effusions and bibasilar airspace opacities . the heart size and mediastinal silhouette are within normal limits for contour . no pneumothorax . stable wedging of the anterior thoracic vertebral bodies . 
1985,2075_IM-0708-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
1986,2077_IM-0710-1001.dcm.png,"right jugular catheter present with tip overlying the lower svc . curvilinear density projecting over the upper chest appears external on the lateral projection . correlate clinically . normal heart size and mediastinal contour appear normal pulmonary vascularity . scar/subsegmental atelectasis in the lingula . no focal airspace consolidation , pleural effusion , or pneumothorax . no acute osseous findings . mild degenerative changes of the spine . "
1987,2078_IM-0710-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
1988,2079_IM-0711-1001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there are calcified granulomas at the right perihilar regions appear stable . there are significant degenerative osteophytes of the thoracic spine also appear stable . "
1989,2080_IM-0712-2002.dcm.png,unknown
1990,2081_IM-0713-1001.dcm.png,the lungs are well-expanded and clear . no pleural effusion or pneumothorax is seen . the cardiomediastinal contour is normal . no acute osseous lesions are identified . 
1991,2082_IM-0714-4004.dcm.png,the heart is enlarged . there is pulmonary vascular congestion with diffusely increased interstitial and mild patchy airspace opacities . the distribution pulmonary edema . there is no pneumothorax or large pleural effusion . there are no acute bony findings . 
1992,2083_IM-0715-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
1993,2084_IM-0715-1001-0001.dcm.png,left chest wall mediport placement with venous catheter tip in superior xxxx . normal cardiac contours . no pneumothorax or pleural effusions . clear lungs bilaterally . fracture seen at t5 and l2 with areas of sclerosis throughout the thoracic and lumbar spine . 
1994,2086_IM-0717-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . lungs are clear without focal consolidation . no visualized pneumothorax or large pleural effusion . no acute bone abnormality . 
1995,2087_IM-0718-3001.dcm.png,unknown
1996,2088_IM-0719-2001.dcm.png,"compared to prior examination from xxxx , there has been extubation and removal of central line and enteric tube . stable cardiomegaly and mild thoracolumbar dextroscoliosis . left basilar opacity represents chronic fibrosis/scar . no focal consolidation , pneumothorax , or effusion . no acute osseous abnormality . "
1997,2089_IM-0720-1001.dcm.png,unknown
1998,2090_IM-0722-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
1999,2091_IM-0722-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . of the spine . 
2000,2092_IM-0723-1001.dcm.png,"there is a rounded opacity in the right lower zone measuring 2 . 0 cm which is to be in the posterobasal segment . there is of uncertain etiology but would benefit from followup at some concern for neoplasm . a is recommended . no airspace disease , effusion or cavitary nodule . normal heart size and mediastinum . visualized of the chest are within normal limits . "
2001,2093_IM-0723-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . a right-sided mediport catheter is noted . no pleural effusion is identified . 
2002,2094_IM-0724-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . prominent pericardial fat is again noted . there is a stable granuloma overlying a lower thoracic vertebral body . the are unremarkable . 
2003,2095_IM-0725-4001.dcm.png,"patchy subsegmental atelectasis is seen bibasilar region , no evidence of pneumothorax or pleural effusion is present . the cardiomediastinal silhouette is unremarkable . old fractures seen the left 9th rib . "
2004,2096_IM-0726-1001.dcm.png,normal heart size and mediastinal contours . clear lungs . no pneumothorax or pleural effusion . unremarkable xxxx . 
2005,2097_IM-0727-1001-0001.dcm.png,the trachea is midline . cardiomediastinal silhouette is normal . the lungs are clear without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no abnormalities . 
2006,2098_IM-0728-1001.dcm.png,the heart size is normal . lungs are clear . there is no pleural line to suggest pneumothorax or costophrenic blunting to suggest large pleural effusion . bony structures are within normal limits . 
2007,2099_IM-0729-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2008,2100_IM-0731-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . atherosclerotic calcification of the aorta . no focal airspace consolidation , pleural effusions or pneumothorax . questionable thin-walled cavitary lesion in the right lower lobe , only seen on the ap view and may represent artifact . no acute bony abnormalities . "
2009,2102_IM-0733-1001.dcm.png,"tortuosity of the aorta . no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . pulmonary vasculature is normal . intact . unchanged eventration of the left hemidiaphragm versus small hernia ( bochdalek ) . "
2010,2103_IM-0734-0001-0001.dcm.png,heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2011,2105_IM-0736-1001.dcm.png,unknown
2012,2106_IM-0736-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2013,2108_IM-0738-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2014,2109_IM-0739-0001-0002.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . surgical clips are present in the abdomen . 
2015,2110_IM-0741-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2016,2111_IM-0741-2001.dcm.png,patchy airspace disease is present in the lateral view probably within the right lower lobe . there is severe underlying emphysema . the aorta is calcified . there is spondylosis . 
2017,2112_IM-0742-1001.dcm.png,"there is 1 . 9 cm interruption of the tunneled left central venous catheter , at the level of the overlap of the clavicle and first rib . catheter tip may be within the proximal svc or azygos vein . normal heart size . left perihilar and midlung densities . no pneumothorax or large pleural effusion . "
2018,2113_IM-0742-1002.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . mild lung hyperinflation . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . degenerative changes seen within the midthoracic spine . there is no visible free intraperitoneal air under the diaphragm . 
2019,2114_IM-0743-4004.dcm.png,unknown
2020,2115_IM-0744-1001.dcm.png,unknown
2021,2116_IM-0745-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax demonstrate healed , remote bilateral rib fractures without acute abnormality . "
2022,2117_IM-0745-1001.dcm.png,stable appearance of chest with no findings of disease progression . heart and mediastinum stable configuration . stable elevation of left hemidiaphragm . lungs clear of consolidation . no pneumothorax or pleural effusion . bony thorax intact . minimal spondylosis of the lower thoracic spine . 
2023,2119_IM-0746-1001.dcm.png,"there is a 1 cm nodule within one of the lung bases , seen only on the lateral view . there is a calcified right hilar lymph node and right granuloma . heart size is normal . no pneumothorax . "
2024,2120_IM-0747-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2025,2121_IM-0747-1001.dcm.png,"the heart size is within normal limits . there is ectasia/tortuosity of the thoracic aorta . calcified hilar lymph xxxx . irregular calcific density projecting over the left lower lobe , stable since and may represent mitral annular calcifications . no focal airspace consolidation , pleural effusions or pneumothorax . degenerative changes of the thoracic spine . no acute bony abnormalities . "
2026,2123_IM-0748-1001.dcm.png,the heart is large . pulmonary are engorged . no infiltrates . aorta is somewhat tortuous . degenerative disc disease is present in the thoracic spine . 
2027,2124_IM-0749-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . degenerative changes of the thoracic spine . 
2028,2125_IM-0749-2001.dcm.png,unknown
2029,2126_IM-0750-12012.dcm.png,unknown
2030,2127_IM-0751-1001.dcm.png,changes post bilateral thoracotomy and sternotomy . intact xxxx . stable position of the epicardial xxxx . mild cardiomegaly . the lungs are clear . bilateral small pleural effusions . 
2031,2128_IM-0752-1001.dcm.png,unknown
2032,2129_IM-0753-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
2033,2130_IM-0755-1001.dcm.png,"cardiomegaly is present . there is interstitial pulmonary edema with the presence of b-lines . there is no pneumothorax . there is an oval , 17 mm nodular opacity projecting between the posterior left 5th and 6th ribs . there is a 10 mm nodular density projecting over the right posterior 4th rib . there is a posterior effusion . normal mediastinal silhouette . t-spine osteophytes . "
2034,2131_IM-0755-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of focal consolidations or pleural effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
2035,2132_IM-0755-1001.dcm.png,the cardiac contours are normal . the lungs are clear . stable granuloma in the left lower lung zone . thoracic spondylosis . 
2036,2133_IM-0756-1001.dcm.png,unknown
2037,2134_IM-0756-1001.dcm.png,unknown
2038,2135_IM-0757-1001.dcm.png,there is no focal consolidation . mild blunting of the posterior costophrenic represent small effusions . no pneumothorax is present . there is moderate cardiomegaly . the pulmonary vasculature is within normal limits . 
2039,2136_IM-0758-3001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
2040,2137_IM-0759-1001.dcm.png,unknown
2041,2138_IM-0760-1001.dcm.png,normal heart size . stable tortuous thoracic aorta . prior granulomatous disease . healed rib fractures appear stable . focal opacity is noted in the left midlung overlying the 9th posterior rib which represents healing rib callus . no pneumothorax or pleural effusion . 
2042,2139_IM-0760-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . calcified right hilar lymph xxxx . heart size is enlarged , pulmonary vascularity within normal limits . sternotomy and prosthetic aortic valve noted . "
2043,2140_IM-0762-1001.dcm.png,the lungs are clear . there are calcified left hilar lymph xxxx . the heart and mediastinum are normal . the skeletal structures are notable for an old apparent fracture at t12-l1 or congenital fusion unchanged from the prior study . 
2044,2141_IM-0763-3001.dcm.png,"the heart size is mildly enlarged . there is tortuosity of the thoracic aorta . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
2045,2142_IM-0764-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . no pneumothorax , pleural effusion , or focal air space consolidation . probable dish of the thoracic spine . "
2046,2143_IM-0765-1001.dcm.png,unknown
2047,2144_IM-0765-1001.dcm.png,"stable calcified hilar and granulomas . lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2048,2145_IM-0766-1001.dcm.png,the cardiomediastinal silhouette is normal . the lungs are clear . there is no pneumothorax or pneumomediastinum . visualized bony structures are normal . 
2049,2146_IM-0766-13013.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2050,2146_IM-0766-2002.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2051,2147_IM-0767-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . mild spondylosis . 
2052,2148_IM-0767-3001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2053,2149_IM-0768-0001-0001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is calcified . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . minimal osteophytes of the thoracic spine . no acute , displaced rib fractures . a calcified granuloma is demonstrated in the left upper lobe . "
2054,2150_IM-0770-1001.dcm.png,"the heart is normal in size . the mediastinum is unremarkable . small nodule seen in the left upper lung , possibly granuloma . the lungs are otherwise clear . "
2055,2151_IM-0771-1001.dcm.png,"hyperinflated lungs with flattened diaphragm and increased retrosternal airspace . no focal alveolar consolidation , no definite pleural effusion seen . heart size within normal limits , the typical findings of pulmonary edema . mild spine dextrocurvature noted . "
2056,2152_IM-0772-1001.dcm.png,"normal heart size . normal mediastinal silhouette . no pneumothorax , pleural effusion or suspicious focal air space opacity . "
2057,2153_IM-0773-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . left hemidiaphragm is elevated . 
2058,2154_IM-0774-1001.dcm.png,unknown
2059,2156_IM-0775-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
2060,2157_IM-0775-1001.dcm.png,unknown
2061,2158_IM-0776-1001.dcm.png,"there are diffuse increased interstitial markings , suggestive of pulmonary fibrosis in bilateral lung xxxx . the fibrosis appears to slightly increased compared to previous examination , in xxxx . the trachea is midline . negative for pneumothorax , pleural effusion . the heart size is normal . "
2062,2159_IM-0776-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . . 
2063,2160_IM-0778-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
2064,2161_IM-0779-1001.dcm.png,"the heart size is upper limits of normal . mediastinal contour appears normal and pulmonary vascularity is within normal limits . otherwise , no focal consolidation , large pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
2065,2162_IM-0779-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . the cardiac silhouette remains moderately enlarged , exaggerated by epicardial fat pads . interstitium is prominent . no focal airspace consolidation or pleural effusion . there is spine spondylosis . "
2066,2163_IM-0779-1001.dcm.png,there is a calcified left upper lobe granuloma . no suspicious pulmonary mass or nodule is identified . there is no focal airspace consolidation . no pleural effusion or pneumothorax . the lungs remain hyperexpanded . stable cardiomediastinal silhouette . calcified mediastinal and hilar lymph are consistent with prior granulomatous disease . there are minimal degenerative changes of the spine . 
2067,2164_IM-0780-1001.dcm.png,unknown
2068,2165_IM-0781-0001-0001.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . there has been interval development of bibasilar opacities . the appearance of the right base opacity atelectasis . the left base opacities could represent early pneumonia or areas of atelectasis . no pneumothorax or pleural effusion is seen . 
2069,2166_IM-0782-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2070,2167_IM-0783-1001.dcm.png,"there is hyperexpansion with mild flattening of diaphragm . cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . contrast retained within the renal collecting xxxx . "
2071,2168_IM-0784-1001.dcm.png,"the heart size is within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
2072,2169_IM-0785-0001-0002.dcm.png,"the lungs are hyperexpanded . there is a large rounded lucency in the right upper lung , large emphysematous xxxx . there are biapical opacities , scarring . no focal airspace consolidation to suggest pneumonia . there is no pleural effusion . no pneumothorax . normal heart size . there are minimal degenerative changes of the spine . "
2073,2169_IM-0785-0001-0003.dcm.png,"the lungs are hyperexpanded . there is a large rounded lucency in the right upper lung , large emphysematous xxxx . there are biapical opacities , scarring . no focal airspace consolidation to suggest pneumonia . there is no pleural effusion . no pneumothorax . normal heart size . there are minimal degenerative changes of the spine . "
2074,2170_IM-0786-1001.dcm.png,unknown
2075,2171_IM-0786-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . no change in the small calcified granuloma in the right upper lobe . heart and mediastinum normal . 
2076,2172_IM-0786-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . biapical fibronodular thickening/scarring . hyperexpanded lungs without focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
2077,2173_IM-0786-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . osseous structures are grossly unremarkable . unchanged degenerative changes to the thoracic spine . "
2078,2174_IM-0787-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours , lungs , pleura , osseous structures and visualized upper abdomen are normal . "
2079,2175_IM-0788-1003.dcm.png,the cardiac and mediastinal silhouettes are unremarkable . the lungs are well expanded and clear . there are no focal air space opacities . there is no pneumothorax or effusion . the bony structures of the thorax are intact with no evidence of acute osseous abnormality . 
2080,2176_IM-0789-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2081,2177_IM-0789-4001.dcm.png,and lateral chest examination was obtained . there is enlarged heart silhouette . decreased lung volumes . lungs demonstrate bibasilar airspace opacities better visualized on lateral view . there is no effusion or pneumothorax . degenerative changes of the bilateral xxxx . 
2082,2178_IM-0790-1001.dcm.png,unknown
2083,2179_IM-0791-1001.dcm.png,flattening of the bilateral hemidiaphragms . lungs are clear . soft tissues and bony structures unremarkable . no pneumothorax or effusion . 
2084,2180_IM-0793-1001.dcm.png,unknown
2085,2181_IM-0793-1001-0001.dcm.png,heart size is moderately enlarged . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is suspected right lower lobe airspace opacity demonstrated on the lateral study . there is a fracture of superior sternotomy unchanged . 
2086,2183_IM-0794-1001.dcm.png,moderate cardiomegaly . bibasilar and perihilar interstitial opacities . no pneumothorax . no pleural effusions . 
2087,2184_IM-0795-1001.dcm.png,"the heart is mildly enlarged . mediastinal contour and pulmonary vascularity are within normal limits . there are streaky left basilar airspace opacities , compatible with atelectasis as seen on comparison abdomen and pelvis ct . there is a left upper lung granuloma . otherwise , no focal consolidation , large pleural effusion , or pneumothorax . appear intact . "
2088,2185_IM-0795-1001.dcm.png,there are low lung volumes with bibasilar opacities representing subsegmental atelectasis . the cardio the cardiac silhouette is of the of normal . there is no pneumothorax or pleural effusion . 
2089,2186_IM-0796-1001.dcm.png,the lungs appear clear . lung volumes are low . the heart and pulmonary appear normal . pleural spaces are clear . 
2090,2187_IM-0797-1001.dcm.png,the heart size is normal . tortuous aorta . calcifications are seen within the aortic xxxx . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . stable calcified granuloma within the lingula . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . surgical clips are seen within the right upper abdomen . 
2091,2188_IM-0798-2002.dcm.png,unknown
2092,2189_IM-0798-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
2093,2190_IM-0800-3001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . spinal stimulator is in with tip overlying the t9 vertebral body . 
2094,2191_IM-0801-1001.dcm.png,there is no acute osseous abnormality . soft tissues are within normal limits . borderline enlargement of the heart . normal vascular markings . left basilar retrocardiac opacity . no pneumothorax . 
2095,2192_IM-0802-2002.dcm.png,no focal lung consolidation . no pneumothorax or pleural effusion . heart size and pulmonary vascularity are within normal limits . minimal degenerative changes of the thoracic spine . the previously<br>described deformity in the midthoracic spine is again seen . there is subcutaneous shunt catheter tubing along the anterior chest wall
2096,2193_IM-0803-1001.dcm.png,"again noted and is blunting of the right pleural space , a effusion or scarring . opacity in the right lung base also appears unchanged , scarring . heart size appears normal , improved from prior study . there is no vascular congestion or edema . there's no pneumothorax . "
2097,2194_IM-0804-10001.dcm.png,unknown
2098,2194_IM-0804-9001.dcm.png,unknown
2099,2195_IM-0805-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are mildly hyperinflated , without evidence of focal airspace disease , pneumothorax , or pleural effusion . incidental note is of an azygos fissure . there are no acute bony findings . "
2100,2197_IM-0807-1001.dcm.png,heart size is normal . there are opacities which appear to above the right fissure . there is mild thickening in the fissure . no pneumothorax . no large pleural effusions . 
2101,2198_IM-0808-1001.dcm.png,"cardiac silhouette , pulmonary vascular pattern within normal limits . no focal infiltrate , pneumothorax or pulmonary edema . no pleural effusion . osseous structures within normal limits . "
2102,2200_IM-0811-1001.dcm.png,low lung volumes . bibasilar atelectasis versus scarring . stable left abdominal surgical clips . the heart size and mediastinal silhouette are within normal limits for contour . no pneumothorax or pleural effusions . the are intact . 
2103,2202_IM-0811-1001.dcm.png,unknown
2104,2203_IM-0812-1001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . there is no pneumothorax , pleural effusion , or focal air space consolidation . old right rib fractures . "
2105,2204_IM-0813-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2106,2205_IM-0814-1001.dcm.png,"heart size is normal . tortuous aorta . irregular 1 . 2 cm opacity in the left upper lung is identified both on pa and lateral views and represents chronic scarring . she has a partial resection of the posterior fourth rib . no pneumothorax . no pleural effusion . no focal infiltrate . anterior wedging of multiple vertebral bodies including t6 , t8 , t11 and t12 . "
2107,2206_IM-0815-2001.dcm.png,"minimal right sided perihilar atelectasis . the trachea is midline . negative for pneumothorax , pleural effusion . the heart size is normal . "
2108,2207_IM-0815-1001.dcm.png,heart size is within normal limits . tortuous thoracic aorta . there is patchy right base airspace disease . no pneumothorax or pleural effusion . there mild degenerative changes throughout the thoracic spine . 
2109,2208_IM-0815-1001.dcm.png,persistent cardiomegaly . no abnormal airspace consolidation . resolved interstitial edema . no pneumothorax or pleural effusion . 
2110,2209_IM-0816-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . emphysematous changes are identified . the lungs are otherwise grossly clear . 
2111,2210_IM-0817-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . . 
2112,2211_IM-0818-1001.dcm.png,there is persistent cardiomegaly with suggestion of left atrial enlargement as evidenced by cardiac contour the lateral image and density on the frontal image . the lungs are clear . no visible pleural effusion or pneumothorax . 
2113,2212_IM-0819-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart and mediastinum are normal . the skeletal structures and soft tissues have a normal appearance . 
2114,2213_IM-0819-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . innumerable bilateral nodules are identified , most of which appear calcified on examination . there is no acute infiltrate or effusion . lingular scarring and/or atelectasis . "
2115,2215_IM-0820-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
2116,2216_IM-0821-85075001.dcm.png,heart size and mediastinal contours are within normal limits . pulmonary vasculature is unremarkable . no focal airspace consolidation . there is mild elevation right hemidiaphragm . no visible pleural effusion or pneumothorax . there are mild degenerative changes along the thoracic spine . 
2117,2217_IM-0822-0001-0002.dcm.png,"heart size borderline enlarged , mediastinal contours appear similar to the from xxxx , noted . right hemidiaphragm eventration . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2118,2218_IM-0823-2001.dcm.png,"the opacity at the left lung base appears stable from prior exam . there is elevation of the left hemidiaphragm is stable . the cardiomediastinal silhouette is enlarged but unchanged . sternotomy are again noted . there is a large amount of distending the stomach , which incidentally was also seen on prior exam of 3 years ago . there is no pneumothorax . "
2119,2218_IM-0823-3001.dcm.png,"the opacity at the left lung base appears stable from prior exam . there is elevation of the left hemidiaphragm is stable . the cardiomediastinal silhouette is enlarged but unchanged . sternotomy are again noted . there is a large amount of distending the stomach , which incidentally was also seen on prior exam of 3 years ago . there is no pneumothorax . "
2120,2219_IM-0823-1001.dcm.png,unknown
2121,2220_IM-0824-4004.dcm.png,the examination consists of frontal and lateral radiographs of the chest . there low lung volumes . there is pulmonary vascular congestion and indistinctness . bibasilar airspace disease is also present . probable left pleural effusion . no evidence of pneumothorax . cardiac silhouette is upper lungs are normally accentuated due to low lung volumes . 
2122,2221_IM-0825-1001.dcm.png,unknown
2123,2222_IM-0826-1001.dcm.png,"lungs are clear bilaterally , with no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . calcified densities within the right paratracheal region and left perihilar region , may represent calcified granulomas . there is a round opacity measuring 2 cm in diameter within the posterior mediastinum . are unremarkable . "
2124,2223_IM-0827-1001.dcm.png,"chest . heart size normal . lungs clear . unremarkable . limited technique . right elbow and forearm . no acute fracture , dislocation or joint effusion . soft tissues unremarkable . left ankle . soft tissue around ankle . there are midfoot degenerative changes and plantar calcaneal enthesophyte . ankle mortise intact . no acute fracture or dislocation . "
2125,2224_IM-0828-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vasculature are within normal limits . scattered granulomas and bilateral perihilar calcified lymph xxxx . stable lingular scarring . no focal consolidation , large pleural effusion or pneumothorax is identified . no bony abnormality . "
2126,2225_IM-0829-3001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
2127,2226_IM-0830-12001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . first rib fracture not well demonstrated on study . . 
2128,2228_IM-0831-1001.dcm.png,unknown
2129,2229_IM-0831-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . surgical clips are seen the right upper quadrant . 
2130,2230_IM-0831-1001.dcm.png,mediastinal contours are normal . heart size is upper limits of normal . lungs are clear . there is no pneumothorax or large pleural effusion . no bony abnormality . 
2131,2231_IM-0831-2001.dcm.png,"heart xxxx , mediastinum , xxxx , bony structures are unremarkable . possible subtle increased opacity in right apex versus technique . otherwise no significant interval change compared to prior study"
2132,2232_IM-0832-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2133,2233_IM-0832-1001.dcm.png,"hyperinflated lungs with flattened diaphragm and increased retrosternal airspace . scattered chronic appearing irregular interstitial markings with no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2134,2234_IM-0833-1001.dcm.png,unknown
2135,2235_IM-0833-1001.dcm.png,there are low lung volumes . cardiac silhouette and mediastinal contours are within normal limits . there is no focal opacity . there is no large pleural effusion . there is no pneumothorax . 
2136,2236_IM-0833-1001.dcm.png,"the cardiac silhouette , mediastinum , and pulmonary vasculature are within normal limits . lungs are clear . no pleural fluid or pneumothorax is appreciated . "
2137,2237_IM-0834-2002.dcm.png,unknown
2138,2238_IM-0835-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2139,2239_IM-0836-1001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show normal size and configuration of the cardiac silhouette . normal pulmonary vasculature and central airways . there is interstitial prominence and is basilar patchy air space opacity . no focal airspace consolidation or pleural effusion . 
2140,2240_IM-0838-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2141,2241_IM-0839-28001.dcm.png,"there are biapical opacities , possibly scarring . lungs otherwise appear clear . no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . right-sided chest catheter tip is at the lower svc . several right axillary surgical clips are noted . there are postoperative changes of right mastectomy . "
2142,2242_IM-0840-1001.dcm.png,unknown
2143,2243_IM-0840-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . there is a stable calcified granuloma within the left lower lobe . there are stable chronic degenerative changes of the thoracic spine . "
2144,2243_IM-0840-4001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . there is a stable calcified granuloma within the left lower lobe . there are stable chronic degenerative changes of the thoracic spine . "
2145,2244_IM-0841-2002.dcm.png,unknown
2146,2245_IM-0842-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
2147,2246_IM-0843-1001.dcm.png,normal heart size and mediastinal contour . right lung base airspace disease on frontal xxxx . opacities in the left lung base consistent with atelectasis . no pneumothorax . no pleural effusion . mild wedge deformity of t12 . 
2148,2247_IM-0844-1001.dcm.png,the cardiomediastinal silhouette is normal in size and appearance . no pleural effusion or pneumothorax . lungs are clear . 
2149,2248_IM-0844-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
2150,2249_IM-0844-1001.dcm.png,unknown
2151,2250_IM-0844-1001.dcm.png,there has been interval sternotomy with mitral valve surgery . there is a small amount of scarring in the left midlung . no focal consolidation . no pleural effusions or pneumothoraces . there is continued cardiomegaly with especially enlarged left atrium . 
2152,2251_IM-0844-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2153,2252_IM-0844-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2154,2253_IM-0845-1002001.dcm.png,there is hyperinflation of the lungs but they are clear . the heart and mediastinum are normal . the skeletal structures are normal . there are bilateral breast prostheses . 
2155,2254_IM-0846-1001.dcm.png,lungs are clear . heart size is normal . no pneumothorax . there are surgical clips seen within the upper abdomen . 
2156,2255_IM-0847-3001.dcm.png,"the trachea is midline . cardiomediastinal silhouette is normal and unchanged from prior examination . there are round calcific densities in the right lung consistent with prior granulomatous disease . otherwise , the lungs are clear without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
2157,2256_IM-0848-1001.dcm.png,and lateral chest examination was obtained . one ap view is expiratory and was repeated . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no focal infiltrates . there is no effusion or pneumothorax . 
2158,2256_IM-0848-3001.dcm.png,and lateral chest examination was obtained . one ap view is expiratory and was repeated . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no focal infiltrates . there is no effusion or pneumothorax . 
2159,2257_IM-0849-1001.dcm.png,no focal areas of consolidation . heart size normal limits . no pleural effusions . no evidence of pneumothorax . degenerative changes thoracic spine . 
2160,2258_IM-0849-1001.dcm.png,"mild hypoventilation with bronchovascular crowding and prominent central and basilar interstitial markings . no focal alveolar consolidation , no pleural effusion demonstrated . considering technical factors heart size within normal limits . "
2161,2259_IM-0850-2001.dcm.png,"bilateral glenohumeral degenerative joint disease . scattered degenerative changes of the thoracic spine . stable mild heart enlargement . prominence of soft tissue density in the upper mediastinum . it is increased from most recent prior exam on xxxx . however , it appears similar compared to exams performed in xxxx . no focal area of consolidation , pleural effusion , or pneumothorax . focal opacity in the left upper lobe represents scarring or related to overlying rib opacity . "
2162,2260_IM-0852-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
2163,2261_IM-0852-1001.dcm.png,"frontal and lateral views of the chest with overlying external cardiac monitor leads show normal size and configuration of the cardiac silhouette . normal pulmonary vasculature and central airways . no focal airspace consolidation or pleural effusion . incidental note of an azygos fissure . there are surgical clips , perhaps from cholecystectomy , in the right upper quadrant . "
2164,2262_IM-0852-1001.dcm.png,right basal airspace opacity . the heart size and mediastinal silhouette are within normal limits for contour . no pneumothorax or pleural effusions . the are intact . 
2165,2263_IM-0853-1001.dcm.png,"heart size moderately enlarged , stable mediastinal contours . opacity in the left lung base . otherwise , no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2166,2264_IM-0854-1001.dcm.png,normal heart size and mediastinal contours . low lung volumes . no focal airspace consolidation . no pneumothorax or pleural effusion . visualized bony structures are unremarkable in appearance . 
2167,2265_IM-0855-1001.dcm.png,unknown
2168,2266_IM-0855-1001.dcm.png,unknown
2169,2266_IM-0855-2001.dcm.png,unknown
2170,2267_IM-0856-2001.dcm.png,the lateral view is degraded by patient motion . lungs are grossly clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
2171,2268_IM-0857-1001.dcm.png,unknown
2172,2269_IM-0858-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the chest is in satisfactory position . there is no pneumothorax . the lungs are clear . 
2173,2270_IM-0859-1001.dcm.png,"cardiomediastinal silhouette is within normal limits in overall size and appearance . aortic xxxx , cardiac apex , and stomach are left-sided . central vascular markings are symmetric and within normal limits . the lungs are normally inflated with no focal airspace disease , pleural effusion , or pneumothorax . dextro-convex scoliotic curvature of the thoracic spine . no acute bony abnormality . "
2174,2271_IM-0860-1001.dcm.png,"again observed is a curvilinear density in the right midlung zone which may represent some pulmonary scarring or thickening of the right fissure . there is minimal blunting of the right posterior costophrenic xxxx , consistent with a small effusion and/or pleural scarring . the lung parenchyma is otherwise clear . there is mild cardiomegaly . there are degenerative changes and a mild dextroscoliosis in the thoracic spine . "
2175,2272_IM-0861-1001.dcm.png,unknown
2176,2273_IM-0861-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
2177,2274_IM-0861-1001.dcm.png,the left and right remain enlarged and unchanged . lungs are free of infiltrates . heart size normal . 
2178,2275_IM-0862-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . there is a right middle lobe nodule which is denser than adjacent is most calcified . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . degenerative endplate changes of the spine . "
2179,2276_IM-0863-1001-0002.dcm.png,this radiograph was available for my interpretation at hours xxxx/xxxx . there are low lung volumes with associated bronchovascular crowding and basilar subsegmental atelectasis . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
2180,2277_IM-0864-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
2181,2278_IM-0864-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . sternotomy are again seen . the cardiomediastinal contours are grossly unchanged . right lung calcified granulomata are again seen . there is no consolidation , pleural effusion or pneumothorax . "
2182,2279_IM-0865-2001.dcm.png,heart size is enlarged . the aorta is unfolded . otherwise the mediastinal contour is normal . there are streaky bibasilar opacities . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2183,2280_IM-0867-1001-0001.dcm.png,unknown
2184,2280_IM-0867-1001-0002.dcm.png,unknown
2185,2280_IM-0867-1001-0003.dcm.png,unknown
2186,2282_IM-0869-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . specifically , no evidence of rib fractures . "
2187,2283_IM-0870-1001.dcm.png,"the heart and mediastinal silhouettes are within normal limits . the lungs are clear without focal airspace opacity , large effusion , or pneumothorax . the are grossly intact . interval removal of right picc . persistent elevation of the left hemidiaphragm . "
2188,2285_IM-0870-2001.dcm.png,sternotomy and mediastinal postsurgical changes . stable cardiomegaly . crowded bronchovascular and interstitial markings related to low lung volumes and technique . grossly stable appearance of the lungs compared to prior exam without overt edema or gross airspace consolidation . 
2189,2286_IM-0871-1001.dcm.png,chronic-appearing opacities are unchanged and represent emphysema . heart size is normal . no large pleural effusions . no pneumothorax . no focal airspace opacities . 
2190,2287_IM-0872-1001.dcm.png,unknown
2191,2288_IM-0872-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . no cavitary lesions . are grossly unremarkable . "
2192,2289_IM-0873-1001.dcm.png,lungs are clear . blunting of the left costophrenic consistent with a small left pleural effusion and associated airspace disease . the right lung is clear . sequelae of old granulomatous disease . heart size is upper limits of normal . degenerative changes in the spine . 
2193,2290_IM-0874-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures are intact . 
2194,2291_IM-0874-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . umbilical piercing . 
2195,2292_IM-0874-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2196,2293_IM-0875-1001.dcm.png,the heart is normal in size . the mediastinum is stable . the previously visualized bilateral pneumothoraces have resolved . right chest wall surgical have been removed . there is improved aeration in the lung bases with mild residual opacities compatible with scarring or atelectasis . 
2197,2294_IM-0876-1001.dcm.png,unknown
2198,2295_IM-0876-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is calcified . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . 
2199,2296_IM-0876-1001.dcm.png,"the heart is normal in size with normal appearance of the cardiomediastinal silhouette . there is a hiatal hernia with soft tissue projecting behind the mediastinum . the lungs are clear without focal airspace opacity , pleural effusion , pneumothorax . the osseous structures are intact . "
2200,2297_IM-0877-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . mild curvature thoracolumbar junction . 
2201,2299_IM-0878-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . peripheral right basilar calcified granuloma . no focal consolidation , pneumothorax or large pleural effusion . apparent nodular opacity on lateral projection , immediately retrocardiac , is to represent confluence of overlapping silhouettes . negative for acute bone abnormality . "
2202,2300_IM-0881-1001.dcm.png,heart size is within normal limits . no focal consolidation . no pneumothorax or pleural effusion . no bony abnormalities . 
2203,2301_IM-0881-2001.dcm.png,"radiographic attenuation obscures detail . grossly , the lungs are clear and expanded . heart is large . pulmonary are normal . "
2204,2302_IM-0882-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . . "
2205,2303_IM-0882-1001.dcm.png,unknown
2206,2304_IM-0882-4004.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
2207,2305_IM-0882-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . slight thoracolumbar curvature is noted . 
2208,2306_IM-0882-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . pulmonary vasculature is normal . intact . mild degenerative change of the lower thoracic spine , anterior osteophytes . "
2209,2307_IM-0882-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hyperinflated with opacities compatible with pleural-parenchymal scarring . there is no acute infiltrate or effusion . 
2210,2308_IM-0883-1001.dcm.png,unknown
2211,2308_IM-0883-3001.dcm.png,unknown
2212,2310_IM-0885-1001.dcm.png,no focal consolidation . no visualized pneumothorax . the heart size is normal . there are no large pleural effusions . 
2213,2311_IM-0886-2001.dcm.png,"normal cardiac size , mediastinum , and central pulmonary vasculature . grossly clear lungs , without focal airspace consolidation , pleural effusion , or pneumothorax . no evidence of displaced rib fractures . normal thoracic vertebral body xxxx . "
2214,2312_IM-0887-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2215,2313_IM-0888-1002001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . there has been sternotomy . the heart and mediastinum are normal . the skeletal structures are normal . 
2216,2314_IM-0889-1001.dcm.png,the lungs are xxxx . opacities are present in the right costophrenic xxxx . no focal infiltrates . heart size normal . 
2217,2315_IM-0889-1003.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . there is calcified granuloma in the left lingula . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2218,2316_IM-0889-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
2219,2317_IM-0890-1001.dcm.png,a calcified granuloma is present in the right costophrenic xxxx . lungs are otherwise clear . heart size normal . 
2220,2318_IM-0891-1001.dcm.png,unknown
2221,2319_IM-0892-3003.dcm.png,unknown
2222,2320_IM-0894-1001.dcm.png,"the cardio mediastinal silhouette , pulmonary vascular pattern are within normal limits . no pneumothorax . no pneumonia . no pleural effusion . mild degenerative changes mid thoracic spine . "
2223,2321_IM-0894-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2224,2321_IM-0894-3001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2225,2322_IM-0894-1001.dcm.png,lung volumes remain xxxx . opacity is present in the right middle lobe . no focal infiltrates . heart size normal . 
2226,2323_IM-0895-12012.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . no acute bony or soft tissue abnormality . "
2227,2324_IM-0895-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
2228,2325_IM-0896-1001.dcm.png,unknown
2229,2326_IM-0897-1001.dcm.png,"heart size mildly enlarged , stable mediastinal and hilar contours . right hemidiaphragm eventration . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2230,2327_IM-0898-1001.dcm.png,there has been interval development of a large right-sided pleural effusion . the left lung is clear . there is no pneumothorax . heart size mediastinal contours are within normal limits . deformity is noted at the upper thoracic vertebral body . 
2231,2328_IM-0898-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are unchanged . again noted is tortuosity and unfolding of the thoracic aorta . aortic vascular calcifications . normal pulmonary vascularity . bone demineralization . 
2232,2331_IM-0900-1001.dcm.png,the heart is near top normal in size with tortuosity of the aorta . the pulmonary vascular markings are symmetric and normal . there are low lung volumes with opacities consistent with focal atelectasis . there is no pleural effusion or pneumothorax . there are degenerative changes in thoracic spine and thoracic kyphosis . 
2233,2332_IM-0900-1001.dcm.png,"the heart and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion , pneumothorax . the osseous structures are intact . "
2234,2334_IM-0902-1001.dcm.png,no acute osseous abnormality . scattered degenerative changes throughout the thoracic spine . stable normal cardiomediastinal silhouette and hilar contours . scattered bilateral granulomas . patchy left basal airspace opacity . bilateral small effusions . 
2235,2335_IM-0902-2001.dcm.png,the heart size is normal . there is normal cardiomediastinal silhouette . lungs are clear bilaterally . thoracic spine shows anterior osteophyte formation . 
2236,2336_IM-0903-1001.dcm.png,lungs are hyperinflated but clear . no focal infiltrate or effusion . heart and mediastinal contours within normal limits . calcified mediastinal identified . 
2237,2336_IM-0903-3001.dcm.png,lungs are hyperinflated but clear . no focal infiltrate or effusion . heart and mediastinal contours within normal limits . calcified mediastinal identified . 
2238,2338_IM-0905-1001.dcm.png,"compared to prior examination , there is significant improvement in aeration bilaterally , with improved bilateral airspace opacities . currently , there are only minimal streaky opacities in the bilateral midlung , which may represent mild residual airspace disease , atelectasis , or underlying changes of chronic lung disease . no large focal consolidations , pneumothorax , or definite pleural effusions identified . the mediastinal silhouette is stable and within normal limits for size and contour . no acute osseous abnormality is identified . "
2239,2338_IM-0905-3001.dcm.png,"compared to prior examination , there is significant improvement in aeration bilaterally , with improved bilateral airspace opacities . currently , there are only minimal streaky opacities in the bilateral midlung , which may represent mild residual airspace disease , atelectasis , or underlying changes of chronic lung disease . no large focal consolidations , pneumothorax , or definite pleural effusions identified . the mediastinal silhouette is stable and within normal limits for size and contour . no acute osseous abnormality is identified . "
2240,2339_IM-0905-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . multiple xxxx-filled loops of bowel are present . gastrostomy is noted . 
2241,2340_IM-0907-1001.dcm.png,"chest . lung volumes are low , but no focal infiltrates are present . heart and mediastinum remain normal . abdomen . multiple slightly distended loops are present from stomach to rectum . formed stool is present in the rectum . "
2242,2341_IM-0907-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
2243,2342_IM-0907-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are unchanged . pulmonary vascularity is within normal limits . calcified right upper lobe nodule with a granuloma is again seen but unchanged . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
2244,2343_IM-0908-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
2245,2344_IM-0909-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated . no focal consolidation is seen . postsurgical/biopsy changes overlying the right breast . 
2246,2345_IM-0910-1001.dcm.png,"the heart size is at the upper limits of normal . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . mild chronic degenerative changes are present within the thoracic spine . . "
2247,2347_IM-0912-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . atherosclerosis of the aortic xxxx . no focal consolidation , pneumothorax or large pleural effusion . t-spine osteophytes . "
2248,2348_IM-0913-1001.dcm.png,there is a moderate sized right pleural effusion . severe slightly smaller than is compared to xxxx . there is a small left pleural effusion . this is unchanged as compared to the prior study . there is a right chest wall venous which appears accessed . no pneumothorax . scaphoid abdomen . 
2249,2349_IM-0914-1001.dcm.png,heart size and vascularity normal . these contour normal . lungs clear . no pleural effusions or pneumothoraces . 
2250,2350_IM-0916-1001.dcm.png,no focal areas of consolidation . no suspicious pulmonary opacities . mild degenerative change thoracic spine . no pleural effusions . no evidence of pneumothorax . heart size normal limits . 
2251,2351_IM-0917-1001.dcm.png,"the heart is normal in size and contour . scattered calcifications are noted , compatible with prior granulomatous disease . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
2252,2352_IM-0918-1002.dcm.png,unknown
2253,2353_IM-0918-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2254,2354_IM-0918-1001.dcm.png,lungs are clear . no pneumothorax or pleural effusion . normal heart and mediastinal contours . normal pulmonary vasculature . bony thorax intact . 
2255,2355_IM-0919-1001.dcm.png,"pa and lateral views the chest were obtained . there are low lung volumes on the frontal view , which accentuates heart size and lung markings . the heart size is upper limits normal or mildly enlarged . mediastinum normal width . the pulmonary vasculature is within normal limits . there is left lung base atelectasis on frontal secondary to low volumes . no pneumothorax , pleural effusion , or focal air space consolidation . "
2256,2356_IM-0920-1001.dcm.png,"low lung volumes . no focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable"
2257,2357_IM-0921-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
2258,2358_IM-0922-0001-0002.dcm.png,"the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities , pleural effusion or pneumothorax . no acute bony abnormalities . "
2259,2360_IM-0925-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
2260,2361_IM-0926-1001.dcm.png,stable mild rightward curvature of the thoracic spine . heart size is normal . no focal airspace disease . no pneumothorax or pleural effusion . no acute osseous findings . 
2261,2362_IM-0926-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2262,2363_IM-0926-1001.dcm.png,heart size is upper limits of normal . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is right basilar air space opacity . 
2263,2364_IM-0927-1001.dcm.png,the lungs are clear . there is hyperexpansion of the lungs suggesting underlying emphysema . the heart and pulmonary appear normal . pleural spaces are clear . mediastinal contours are normal . 
2264,2365_IM-0927-3001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2265,2366_IM-0928-1001.dcm.png,unknown
2266,2367_IM-0928-1001.dcm.png,there is no focal consolidation . there is no pneumothorax or large pleural effusion . the cardiomediastinal contours are grossly unremarkable . the heart size is within normal limits . 
2267,2368_IM-0928-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . there is mild degenerative changes of the thoracic spine . 
2268,2370_IM-0931-1001.dcm.png,"in the interval , consolidation and atelectasis have developed in the right lower lobe . costophrenic blunted on the right . left lung clear . heart size normal . "
2269,2371_IM-0932-1001.dcm.png,there are t-spine osteophytes . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are low lung volumes . 
2270,2372_IM-0933-0001-0001.dcm.png,low lung volumes are present . the heart size and pulmonary vascularity appear within normal limits . bandlike opacities are present in the right lung . appearance suggest atelectasis . no pneumothorax or pleural effusion is seen . 
2271,2373_IM-0934-1001.dcm.png,"normal heart size . dilated pulmonary arteries . atherosclerotic calcifications of the aorta . no focal airspace consolidation . decreased biapical vascular markings with moderate hyperexpansion the lungs , consistent with obstructive pulmonary disease . no pleural effusion or pneumothorax . "
2272,2374_IM-0935-84550001.dcm.png,unknown
2273,2375_IM-0936-1001.dcm.png,"cardiac silhouette is upper limits of normal in size . normal mediastinal contour and pulmonary vasculature . there is evidence of healed granulomatous disease in the right hemithorax . lungs are without focal airspace consolidation , large pleural effusion or pneumothorax . "
2274,2376_IM-0936-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours , lungs , pleura , osseous structures and visualized upper abdomen are normal . "
2275,2377_IM-0937-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2276,2378_IM-0938-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . stable left lower lobe calcified granuloma . remote left clavicle fracture . "
2277,2379_IM-0939-1001.dcm.png,cardiomediastinal silhouette is within normal limits of size and appearance . lungs are hyperlucent and hyperexpanded . negative for focal airspace disease or consolidation . negative for pneumothorax or pleural effusion . limited evaluation reveals no acute abnormality . 
2278,2380_IM-0940-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . the left hemidiaphragm is elevated . this is unchanged . no focal airspace disease is seen . no pneumothorax or pleural effusion is noted . there is eventration of the right hemidiaphragm . 
2279,2381_IM-0941-1001.dcm.png,cardiac and mediastinal contours are within normal limits . granulomatous calcifications are present . the lungs are otherwise clear . bony structures are intact . prior cholecystectomy . 
2280,2382_IM-0941-2001.dcm.png,moderate cardiomegaly with narrowed severe mediastinal contours . been sternotomy noted . no pneumothorax . no large pleural effusions . no focal lung consolidation . 
2281,2383_IM-0941-1001.dcm.png,"stable cardiomegaly , at partially accentuated by low lung volumes . stable sternotomy xxxx , several of which are interrupted , and mediastinal clips . no focal consolidation , pneumothorax or large pleural effusion . t-spine osteophytes . "
2282,2384_IM-0942-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . a large hiatal hernia is noted . the lungs are free of focal airspace disease . no pneumothorax or pleural effusion is seen . degenerative changes are present in the spine . 
2283,2385_IM-0942-1001.dcm.png,unknown
2284,2386_IM-0942-1001.dcm.png,heart size is normal . no pneumothorax or pleural effusions . there is an 8 mm calcified nodule in the left midlung . there is also a 7 mm calcified nodule near the left hilum . hyperexpanded lungs consistent with chronic obstructive pulmonary disease . 
2285,2387_IM-0943-1001.dcm.png,heart size is upper limits of normal for ap projection . mediastinal contours and pulmonary vasculature are unremarkable . the patient's chin obscures the bilateral lung apices . there is no focal airspace consolidation . no visible pleural effusion or pneumothorax . no displaced rib fractures are seen . there are moderate degenerative changes along the thoracic spine . 
2286,2388_IM-0944-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2287,2389_IM-0944-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
2288,2390_IM-0944-1001.dcm.png,the heart is borderline in size . the mediastinum is stable with changes of sternotomy and bypass graft . aorta is atherosclerotic . there are postsurgical changes of the left hemithorax with mild left-sided volume loss as evidenced by diaphragm elevation . left post thoracotomy rib changes are noted . the right lung is clear . there is no pleural effusion . 
2289,2391_IM-0944-1001.dcm.png,lungs are clear without focal infiltrates . no pneumothorax or pleural effusion . normal heart size . normal pulmonary vascularity . bony thorax intact . 
2290,2392_IM-0944-1001.dcm.png,"heart size and mediastinal contour within normal limits . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
2291,2393_IM-0944-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are hyperexpanded but clear . biapical scarring noted . no pleural effusions or pneumothoraces . 
2292,2394_IM-0944-1001.dcm.png,"cardiac and mediastinal appear normal . no visible pneumothorax , focal airspace opacity , or pleural effusion is seen . no visible free air under the diaphragm . the osseous structures appear intact . "
2293,2395_IM-0944-1001.dcm.png,normal cardiomediastinal contours . lungs are clear . no pneumothorax . 
2294,2396_IM-0945-1001.dcm.png,there are bilateral opacities most prominent in the lower lobes bilaterally . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . there is an embolization overlying left upper quadrant . 
2295,2397_IM-0946-1001.dcm.png,"stable normal cardiac size and contour , normal mediastinal silhouette . normal pulmonary xxxx . lungs clear , no airspace disease . no pleural effusion or pneumothorax . "
2296,2398_IM-0947-12012.dcm.png,"patient is rotated . mild cardiomegaly . low lung volumes with elevated hemidiaphragms , greater on the right . this is identified on a thoracic study from as well . no pneumothorax . no large pleural effusion . no focal infiltrate . "
2297,2398_IM-0947-4004.dcm.png,"patient is rotated . mild cardiomegaly . low lung volumes with elevated hemidiaphragms , greater on the right . this is identified on a thoracic study from as well . no pneumothorax . no large pleural effusion . no focal infiltrate . "
2298,2400_IM-0950-1001.dcm.png,unknown
2299,2401_IM-0950-1001.dcm.png,"cardiomediastinal silhouette is within normal limits of size and appearance . the pulmonary vascularity is unremarkable . lungs are expanded and clear airspace disease . negative for pneumothorax , pleural effusion , or pneumoperitoneum . limited bone evaluation reveals no acute abnormality . "
2300,2402_IM-0951-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . there are low lung volumes with left basilar subsegmental atelectasis . no focal airspace consolidation , effusions or pneumothorax . no acute bony abnormalities . "
2301,2403_IM-0951-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . stable left basilar atelectasis versus scarring . 
2302,2404_IM-0952-1001.dcm.png,unknown
2303,2405_IM-0953-1001.dcm.png,unknown
2304,2406_IM-0954-1001.dcm.png,both lungs remain clear and expanded . heart and pulmonary are normal . no change in the large hiatus hernia . 
2305,2407_IM-0954-1001.dcm.png,some hyperinflation appears to be present . there are small calcified granulomas . the lungs are otherwise clear . the heart is normal . the mediastinum is normal . the skeletal structures and soft tissues are normal . 
2306,2408_IM-0955-4004.dcm.png,"cardiomediastinal contour stable and within normal limits . changes of prior cabg again noted . normal pulmonary vascularity . streaky bibasilar opacities decreased from previous , possibly subsegmental atelectasis and/or scar . no pneumothorax or pleural effusion demonstrated . redemonstrated severe l1 fracture . slight interval increase in loss of t11 and there is mild to moderate anterior loss of t10 . degenerative changes of the spine . abdominal aortic stent . "
2307,2409_IM-0955-1001.dcm.png,"frontal and lateral views . the cardiac silhouette is on the upper limits normal for size . interstitial opacities are persistent at both lung bases . calcified granulomas are also identified . compared to the previous ct scan , there has been no significant interval change . no developing airspace opacity , or pneumothorax . "
2308,2410_IM-0956-1001.dcm.png,the heart size is normal and cardiomediastinal silhouette has normal contour . the left hilar calcified lymph appear stable . there is persistence of a left lower lobe calcified nodule representing a granuloma . the lungs are hyperinflated but otherwise clear bilaterally . 
2309,2411_IM-0957-0001-0002.dcm.png,"mild cardiomegaly , stable mediastinal contours . no focal alveolar consolidation , no definite pleural effusion seen . mild bronchovascular crowding without typical findings of pulmonary edema . "
2310,2412_IM-0958-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits . no pneumothorax or pleural effusions . the lungs are clear . no focal consolidations . the osseous structures are intact . calcification in the right upper quadrant of the abdomen consistent with gallstone . 
2311,2413_IM-0959-1001.dcm.png,"heart size and pulmonary vascularity within normal limits . no focal infiltrate , pneumothorax or pleural effusion identified . "
2312,2415_IM-0961-1001.dcm.png,the heart is mildly enlarged . the lungs are hypoinflated with mildly elevated left hemidiaphragm . there is patchy opacity in the left lung base which may be secondary to atelectasis and/or possible infiltrate . increased markings are noted throughout and were present on prior ct . the study is limited secondary to moderate motion . underlying emphysematous changes are identified . 
2313,2416_IM-0961-1001.dcm.png,the outside x-xxxx is normal except for slight cardiomegaly . 
2314,2417_IM-0961-1001.dcm.png,stable cardiomediastinal silhouette . calcified granuloma in the left lower lobe . minimal bibasilar airspace disease . no pneumothorax . degenerative changes of the thoracic spine . 
2315,2418_IM-0962-5001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . note is of calcifications in the aortic xxxx . the lungs are clear , without evidence of focal infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . there is calcification of the chondral portions of the ribs . "
2316,2419_IM-0963-1001.dcm.png,unknown
2317,2420_IM-0964-0001-0001.dcm.png,the heart is normal in size . the mediastinum is within normal limits . aorta is tortuous . right chest tip is visualized at the proximal right atrium . the lungs are grossly clear . no pneumothorax is seen . there are deformities of the left lateral 7th and 8th ribs possibly healing or old fractures . 
2318,2422_IM-0965-1001.dcm.png,consolidation is developing in the left lower lobe . a patchy infiltrate is also present in the right lower lobe . heart size is normal . 
2319,2423_IM-0965-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2320,2424_IM-0966-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . the mediastinum is normal . arthritic changes of the skeletal structures are noted . 
2321,2425_IM-0967-1001.dcm.png,lung volumes are low . no infiltrates . heart and mediastinum are normal . 
2322,2425_IM-0967-3001.dcm.png,lung volumes are low . no infiltrates . heart and mediastinum are normal . 
2323,2427_IM-0969-4001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal and unchanged compared to prior examination . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . there is hiatal hernia . "
2324,2428_IM-0970-1001.dcm.png,"lungs mildly hyperinflated with flattened posterior diaphragm and increased retrosternal airspace . no focal alveolar consolidation , no definite pleural effusion seen . left hilar calcifications and dense left lower lobe nodules suggest a previous granulomatous process . overall heart size within normal limits with prominent right atrial convexity , no typical findings of pulmonary edema . no pneumothorax . "
2325,2431_IM-0973-1001.dcm.png,lungs are clear . no focal airspace consolidation or pleural effusion . heart size is normal . no pneumothorax . calcified lymph xxxx . 
2326,2432_IM-0974-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2327,2433_IM-0975-2001.dcm.png,"low lung volumes with bibasilar subsegmental atelectasis . no focal consolidations , pleural effusions , or pneumothoraces . cardiomediastinal silhouette is within normal limits . degenerative changes of the thoracic spine . "
2328,2433_IM-0975-3001.dcm.png,"low lung volumes with bibasilar subsegmental atelectasis . no focal consolidations , pleural effusions , or pneumothoraces . cardiomediastinal silhouette is within normal limits . degenerative changes of the thoracic spine . "
2329,2434_IM-0976-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there is biapical scarring . the lungs are otherwise clear . 
2330,2435_IM-0976-1001.dcm.png,unknown
2331,2436_IM-0976-1001.dcm.png,unknown
2332,2437_IM-0977-2002.dcm.png,the lungs appear clear . the heart and pulmonary are normal . mediastinal contours are normal . the pleural spaces are clear . 
2333,2438_IM-0978-4004.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
2334,2439_IM-0978-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hyperinflated . there is biapical scarring . no acute infiltrate or pleural effusion seen . 
2335,2440_IM-0978-2001.dcm.png,the heart is normal in size . the mediastinum is stable . the aorta is atherosclerotic . emphysematous changes are identified . there is no acute infiltrate or effusion . 
2336,2441_IM-0978-1001.dcm.png,"there is mild blunting of the right costophrenic which may represent a small right pleural effusion . no focal consolidation or pneumothorax identified . cardiomediastinal silhouette demonstrates stable mild tortuosity of the thoracic aorta , and heart size within normal limits and stable . no acute osseous abnormality . there is redemonstration of mild multilevel degenerative disc disease of the thoracolumbar spine . old , healed left rib fractures are noted . "
2337,2442_IM-0979-1001.dcm.png,"given differences in patient rotation , heart size and mediastinal contours are grossly unchanged . lungs appear clear without focal consolidation . no visible pleural effusion or pneumothorax . stable degenerative changes of the thoracic spine with scattered deformities . stable postsurgical changes of the left shoulder and marked degenerative changes of the right shoulder . "
2338,2443_IM-0980-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . vascular calcification is noted . 
2339,2444_IM-0980-1001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . acromioclavicular joint degenerative change . 
2340,2445_IM-0981-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2341,2446_IM-0982-1001.dcm.png,"the heart and lungs have in the interval . both lungs are clear and expanded . the aorta is tortuous , but the heart and mediastinum otherwise normal . "
2342,2447_IM-0983-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . calcified right hilar lymph are demonstrated . atherosclerotic calcifications of the aortic xxxx . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . mild to moderate degenerative changes of the thoracic spine . 
2343,2448_IM-0983-1001.dcm.png,mediastinal contours are normal . no significant change in pneumothorax or right pleural fluid . . 
2344,2449_IM-0984-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . again seen is paraspinal foreign body which may represent a bullet fragment . 
2345,2450_IM-0986-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is identified . 
2346,2451_IM-0987-1001.dcm.png,chest . heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . mild degenerative changes throughout the thoracic spine . right knee . there has been prior ligamentous repair . there is tricompartmental joint space narrowing and marginal osteophyte formation which is severe in the medial compartment . no knee joint effusion . no fractures or dislocations . 
2347,2453_IM-0988-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2348,2454_IM-0989-1001.dcm.png,cardiomediastinal silhouette appears normal in size and contour . right lung is clear . stable blunting of costophrenic with improved aeration of the left base compared to prior exam . no visualized pneumothorax or focal consolidation . unremarkable . 
2349,2455_IM-0989-1001.dcm.png,unknown
2350,2456_IM-0989-1001.dcm.png,"mild cardiomegaly . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . there is thoracic kyphosis . there is deformity of t12 and l1 , unchanged abdomen xxxx , xxxx . aortic calcifications are noted . fracture of right proximal humerus , incompletely evaluated . "
2351,2457_IM-0989-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours , lungs , pleura , osseous structures and visualized upper abdomen are normal . "
2352,2458_IM-0990-1001.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . mild degenerative changes thoracic spine . "
2353,2459_IM-0991-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
2354,2460_IM-0993-1001.dcm.png,unknown
2355,2461_IM-0994-0001-0002.dcm.png,unknown
2356,2462_IM-0995-1001.dcm.png,"there is stable cardiomegaly . aorta is calcified and tortuous . there are multiple pleural calcifications representing prior asbestos exposure . these appear unchanged . there is no pneumothorax , pleural effusion , or focal airspace consolidation . "
2357,2463_IM-0996-1001.dcm.png,unknown
2358,2464_IM-0997-1001.dcm.png,the lungs appear clear . there are no suspicious appearing pulmonary nodules or masses . there is no evidence of pneumonia . the heart pulmonary appear normal . pleural spaces are clear . mediastinal contours are normal . 
2359,2465_IM-0997-1001.dcm.png,"heart size is mildly enlarged but stable . . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2360,2466_IM-0997-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
2361,2467_IM-0997-1001.dcm.png,"negative for cardiac enlargement . negative for vascular congestion . there are several small circular opacities in the right upper lung , some of which are centrally lucent . negative for bony abnormality . "
2362,2468_IM-0998-1001.dcm.png,unknown
2363,2469_IM-0999-1001.dcm.png,"there is mild opacification over both xxxx , secondary to soft tissue attenuation . there are no focal air space opacities . no pleural effusion or pneumothorax . cardiomediastinal silhouette is within normal limits . trachea is midline . no free subdiaphragmatic air . "
2364,2470_IM-1001-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . no focal airspace disease . no large pleural effusion or pneumothorax . the are intact . 
2365,2470_IM-1001-3001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . no focal airspace disease . no large pleural effusion or pneumothorax . the are intact . 
2366,2471_IM-1002-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal and unchanged compared to prior examination . lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
2367,2473_IM-1003-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated but clear . 
2368,2474_IM-1003-1001.dcm.png,"patchy interstitial infiltrates have developed in both lower lobes . both costophrenic are blunted . aorta is somewhat tortuous , with the heart size is normal . pulmonary are normal . "
2369,2475_IM-1004-1001.dcm.png,heart size remains slightly large . pulmonary are normal . aorta tortuous . 
2370,2476_IM-1005-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
2371,2477_IM-1006-1001.dcm.png,"intact sternotomy xxxx . stable cardiomegaly with grossly unchanged rightward mediastinal shift . unchanged appearance of left perihilar calcified lymph and left basilar calcified granuloma . relatively unchanged appearance of prominent interstitial markings with patchy bibasilar atelectasis . the negative for pneumothorax , focal infiltrate , or large pleural effusion . no acute bony abnormalities . "
2372,2478_IM-1007-1001.dcm.png,there your regular interstitial changes and possibly fibrosis in the left mid and lower lung zone and region of the right middle lobe . hyperinflation is present . no focal consolidation is seen . there is no evidence for pleural effusion . the heart is not enlarged . mediastinum is normal . there are arthritic changes of the spine . 
2373,2480_IM-1009-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
2374,2482_IM-1011-0001-0002.dcm.png,unknown
2375,2483_IM-1012-1001.dcm.png,there has been previous aortic valve replacement . heart is towards upper limits normal for size and may be mild pulmonary vascular congestion . the skeletal structures are normal . the soft tissues are normal . 
2376,2484_IM-1012-1001.dcm.png,"frontal and lateral views of the chest with overlying external cardiac monitor leads show normal size and configuration of the cardiac silhouette . there are scattered nodular opacities , calcified granulomas . no focal airspace consolidation or pleural effusion . "
2377,2485_IM-1013-1001.dcm.png,"there is bilateral lower lung airspace disease . there are small to moderate sized bilateral pleural effusions , left greater than right . there is no pneumothorax . mediastinal silhouette normal . calcified left hilar lymph xxxx . "
2378,2486_IM-1014-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . there are no focal infiltrates . there is prominent epipericardial fat . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . right 7th and 8th rib deformities are noted . there is no visible free intraperitoneal air under the diaphragm . 
2379,2487_IM-1014-1001.dcm.png,"chest: the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . thoracic spine: mild dextro curvature the upper thoracic spine . evaluation of the upper thoracic bodies is limited secondary to osseous overlap . vertebral body and disc spaces are maintained . mild degenerative endplate changes . lumbar spine: there are 5 nonrib-bearing lumbar type vertebral bodies . alignment is within normal limits . vertebral body and disc spaces are maintained . mild degenerative change without acute displaced fracture or dislocation . moderate amount of stool . . "
2380,2488_IM-1015-1001.dcm.png,unknown
2381,2489_IM-1016-1001.dcm.png,the heart and mediastinum are unremarkable . the lung volumes are low . there is a calcified granuloma in the right hilum . minimal atelectasis or scarring in the left lower lobe . there is no effusion or pneumothorax . 
2382,2490_IM-1017-1001.dcm.png,unknown
2383,2491_IM-1017-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
2384,2492_IM-1018-1001.dcm.png,the the cardiac silhouette and pulmonary vascularity are normal . atherosclerotic changes are present in the thoracic aorta . the lungs are clear with no evidence of pleural effusion or pneumothorax . deformity of multiple left anterior ribs are present from previous fractures . lumbar scoliosis is noted . 
2385,2493_IM-1019-8001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of focal infiltrate or effusion . there is no pleural effusion or pneumothorax . the visualized bony structures reveal no acute abnormalities . "
2386,2494_IM-1020-1001.dcm.png,heart size is mildly enlarged . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are mild degenerative changes of the spine . there are extensive vascular calcifications . there is a left midlung calcified granuloma . 
2387,2495_IM-1021-1001.dcm.png,unknown
2388,2497_IM-1022-1001.dcm.png,unknown
2389,2498_IM-1022-1001.dcm.png,unknown
2390,2501_IM-1027-1001.dcm.png,"cardiomediastinal silhouette is within normal limits for size and contour . lungs are hyperinflated with flattening of the diaphragms consistent with emphysematous change . no evidence of focal airspace disease , pleural effusion , or pneumothorax . multilevel degenerative changes of the spine are noted . "
2391,2502_IM-1027-1001-0002.dcm.png,there is a focal area of opacity in the right midlung zone . this was not present on the recent prior study . there is prominence of the pulmonary markings throughout and there are small bilateral pleural effusions . the heart is not significantly enlarged . there is a prosthetic valve . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
2392,2503_IM-1028-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
2393,2504_IM-1029-2001.dcm.png,no focal areas of consolidation . no suspicious bony opacities . heart size within normal limits . no pleural effusions . no pneumothorax . 
2394,2505_IM-1029-1001.dcm.png,normal heart size and mediastinal contours . calcified aortic xxxx . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable appearance . 
2395,2506_IM-1029-1001.dcm.png,cardiomegaly . there is no pulmonary edema . there is no focal consolidation . there are no of pleural effusion . there is no evidence of pneumothorax . 
2396,2507_IM-1030-3001.dcm.png,there is bibasilar airspace disease . cardiac silhouette is within normal limits and stable . there is blunting of the right costophrenic unchanged scarring . no pneumothorax . 
2397,2509_IM-1031-1001.dcm.png,"the lungs are hyperexpanded , with increased ap diameter of the chest . the cardiomediastinal silhouette is stable and normal . there is no pneumothorax or large pleural effusion . "
2398,2510_IM-1033-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the thoracic spine . 
2399,2511_IM-1034-1001.dcm.png,"sternotomy noted . suture material overlies the left upper lobe . heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion or pneumothorax . scarring left costophrenic xxxx , unchanged . calcified granulomas noted . "
2400,2512_IM-1034-1001.dcm.png,unknown
2401,2513_IM-1035-1001.dcm.png,[<heart size and pulmonary vascularity within normal limits . there is a large hiatal hernia seen projecting in the retrocardiac region . this is from prior examination . there is associated atelectasis in the left lung base . no pleural effusion or pneumothorax is identified . 
2402,2514_IM-1036-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . there are residuals of prior granulomatous infection . lungs otherwise clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
2403,2515_IM-1036-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
2404,2516_IM-1036-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . stable mild hyperinflation , right apical pleural-parenchymal irregularities compatible with scarring . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
2405,2517_IM-1036-1001.dcm.png,lungs are clear . no pneumothorax or pleural effusion . normal heart and mediastinal contours . normal pulmonary vasculature . bony thorax intact . 
2406,2518_IM-1036-1001.dcm.png,no the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are t-spine osteophytes . 
2407,2519_IM-1037-1001.dcm.png,"there is mild cardiomegaly , similar to prior exams . no focal consolidation . no visible pleural effusion or pneumothorax . "
2408,2520_IM-1039-27001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . a few bandlike opacities are present which are to represent small areas of scarring or atelectasis . there is eventration of the right hemidiaphragm . calcified granuloma is present in the left lung . 
2409,2522_IM-1040-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . chronic appearing left greater than right lung base scarring with possible small effusions . no pneumothorax . visualized osseous structures are unremarkable in appearance . 
2410,2523_IM-1041-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
2411,2524_IM-1042-1001.dcm.png,the cardiac contours are normal . prior granulomatous disease . the lungs are clear . thoracic spondylosis . 
2412,2526_IM-1043-1001.dcm.png,unknown
2413,2527_IM-1043-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
2414,2528_IM-1044-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
2415,2529_IM-1044-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2416,2530_IM-1045-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the ascending aorta is prominent and descending thoracic aorta is is tortuous . aorta appears unchanged as compared to the study . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no discrete nodules are identified . there is an oblong density projecting over the anterior left 7th rib . appearance suggests an old rib fracture . 
2417,2531_IM-1045-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . scattered calcified granulomas noted . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax demonstrate mild multilevel degenerative disc disease of the thoracolumbar spine without acute abnormality . "
2418,2532_IM-1046-1001.dcm.png,"stable enlargement of the cardiac silhouette , lateral view interlobar fissural thickening . interstitial opacities greatest in the central lungs and bases . "
2419,2533_IM-1047-1001.dcm.png,cardiomediastinal silhouette and central pulmonary vasculature are within normal limits . there is no focal air space opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is demonstrated . 
2420,2536_IM-1049-1001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . mediastinal contours are normal . surgical clips are identified in the mediastinum . pleural spaces are clear . soft tissue previously noted along the right lateral chest wall has resolved . 
2421,2537_IM-1049-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . right-sided aortic xxxx . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . there is right basal patchy opacity and bibasal atelectasis or scarring . there is no pleural effusion or pneumothorax . right apical calcified granuloma noted . "
2422,2538_IM-1050-1001.dcm.png,normal heart size and mediastinal contours . no abnormal airspace opacities or large cavitary lung lesions . visualized osseous structures are unremarkable in appearance . 
2423,2539_IM-1050-1001.dcm.png,normal cardiomediastinal contours . no pneumothorax or pleural effusions . no focal lung consolidation . 
2424,2539_IM-1050-3001.dcm.png,normal cardiomediastinal contours . no pneumothorax or pleural effusions . no focal lung consolidation . 
2425,2540_IM-1052-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2426,2541_IM-1053-3001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute , displaced rib fractures identified . "
2427,2542_IM-1053-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . [pulmonary vascularity is within normal limits>] . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
2428,2543_IM-1054-2001.dcm.png,unknown
2429,2544_IM-1054-1001.dcm.png,heart is mildly enlarged but stable . pulmonary vascularity is normal . the patient is status post valve replacement . sternotomy intact . no focal airspace disease or effusion . residuals of prior granulomatous infection . degenerative change of the spine . no pneumothorax . 
2430,2545_IM-1054-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . lung are clear without evidence of effusion , infiltrate , or pneumothorax . visualized bony structures are intact . visualized soft tissues appear normal . "
2431,2546_IM-1055-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the thoracic aorta is tortuous . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2432,2547_IM-1055-4004.dcm.png,normal heart size and mediastinal contours . there is interval improvement in the right lower lobe airspace disease . there is mild air space opacity in that distribution . no airspace disease . no pneumothorax or pleural effusion . 
2433,2548_IM-1056-0001-0001.dcm.png,unknown
2434,2549_IM-1057-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
2435,2551_IM-1058-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
2436,2552_IM-1058-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable"
2437,2553_IM-1059-1001.dcm.png,there are several small calcified granulomas . the lungs are otherwise clear . no focal airspace consolidation . no suspicious pulmonary mass or nodule is identified . there is no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . there are diffuse degenerative changes of the spine . 
2438,2554_IM-1059-1001.dcm.png,this is a stable normal cardiomediastinal silhouette . the lungs are mildly hyperexpanded . some blunting of the left costophrenic represent scarring or atelectasis . no large pneumothorax or effusion . there are no acute osseous abnormalities . 
2439,2555_IM-1060-1001.dcm.png,heart size is normal . mild lung hyperexpansion . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
2440,2557_IM-1061-4004.dcm.png,unknown
2441,2558_IM-1062-10001.dcm.png,there is no focal consolidation . there is no pneumothorax or large pleural effusion . the cardiomediastinal contours are grossly unremarkable . the heart size is within normal limits . 
2442,2559_IM-1063-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2443,2560_IM-1064-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . stable calcified granuloma in the left upper lung . no acute bony abnormality is identified . 
2444,2560_IM-1064-3001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . stable calcified granuloma in the left upper lung . no acute bony abnormality is identified . 
2445,2561_IM-1064-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2446,2562_IM-1065-1001.dcm.png,"the heart size is normal . the mediastinal contour is within normal limits . low lung volumes and bronchovascular crowding . mild bibasilar opacities , atelectasis . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . stable degenerative change throughout the thoracic spine . stable thoracolumbar retrolisthesis . there is no visible free intraperitoneal air under the diaphragm . "
2447,2563_IM-1066-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2448,2564_IM-1067-1001.dcm.png,"normal cardiac size and contour unremarkable mediastinal silhouette . lungs clear , no airspace disease , pleural effusion , or pneumothorax . no active/acute cardiopulmonary disease . "
2449,2565_IM-1068-1002.dcm.png,the heart is normal in size . the aorta is tortuous . the lungs are hypoinflated . no focal consolidation or pleural effusion seen . old right-sided rib fracture is noted . 
2450,2566_IM-1068-1001.dcm.png,unknown
2451,2567_IM-1069-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2452,2568_IM-1070-1001.dcm.png,sternotomy appear intact . there is no pleural effusion or pneumothorax . the cardiomediastinal silhouette is within normal limits . the pulmonary vasculature is within normal limits . there is no focal lung opacity . clips overlie the right upper quadrant . 
2453,2569_IM-1071-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . atherosclerotic calcifications present within the thoracic aorta . there is no pleural effusion , pneumothorax , or focal airspace disease . mild emphysematous changes are noted . bilateral apical pleural scarring is present . calcified granuloma is present within the right lower lobe . the are generally unremarkable . "
2454,2570_IM-1073-1001.dcm.png,"there has been interval increase in size of the cardiac silhouette from xxxx . the cardiac fluid is now mildly enlarged . pulmonary vasculature is increased with mildly increased interstitial markings and fissural thickening , suggesting mild pulmonary edema . there is no focal airspace disease , pneumothorax , or large pleural effusion . descending thoracic aorta is tortuous . there are no acute bony findings . "
2455,2572_IM-1073-1001.dcm.png,lungs are clear without focal consolidation . no suspicious pulmonary nodules identified . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
2456,2573_IM-1074-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2457,2574_IM-1074-1001.dcm.png,unknown
2458,2575_IM-1075-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . there are endplate changes within the spine . 
2459,2576_IM-1076-1001.dcm.png,no change in the appearance of the left upper lobectomy . left parahilar scar is unchanged . no infiltrates or masses in the lungs . heart size remains normal . 
2460,2577_IM-1077-1001.dcm.png,"cardiomediastinal silhouette within normal limits . no acute bony abnormality . there are opacities , atelectasis versus airspace disease . no large effusion or pneumothorax . "
2461,2578_IM-1078-1001.dcm.png,"the lungs are clear . no suspicious pulmonary mass or nodule is identified . there is no pleural effusion or pneumothorax . heart size and mediastinal contour are normal . there are sclerotic lesions within the xxxx , better visualized on the comparison scan . there are several bilateral rib fractures with evidence of the callus formation . the appearance is similar to the prior chest radiograph . "
2462,2579_IM-1078-1001.dcm.png,"the lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax unremarkable . "
2463,2580_IM-1078-1001.dcm.png,heart size and mediastinal contours are unchanged . stable right upper lobe scarring with pleural thickening . no consolidation . no visible pleural effusion or pneumothorax . 
2464,2581_IM-1079-1001.dcm.png,"chest . the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are minimal degenerative changes of the spine . there is flattening of the hemidiaphragms . abdomen . there is a normal bowel pattern . there is an ivc identified . there are phleboliths in pelvis . there mild degenerative changes of the spine . "
2465,2583_IM-1081-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2466,2584_IM-1081-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
2467,2585_IM-1082-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . there is mild blunting of the right costophrenic on the frontal view . there is also mild obscuration of the right cardiac xxxx . airspace disease in expected location of right middle lobe also noted on the lateral view to no pleural effusion . left lung clear . degenerative changes spine . no pneumothorax . 
2468,2586_IM-1083-1001.dcm.png,unknown
2469,2588_IM-1083-1001.dcm.png,"no focal consolidation , pneumothorax or definite pleural effusion . nodular density projected over the left base with no lateral view correlate secondary to soft tissue overlay . heart size and pulmonary vascularity within normal limits , no mediastinal widening characteristic in appearance of vascular injury . no acute osseous injury demonstrated . "
2470,2589_IM-1083-1001.dcm.png,"there are no acute osseous abnormalities . soft tissues are within normal limits . there is stable enlargement of the heart . calcific aorta . stable bilateral calcified granulomas . the lungs are clear bilaterally without focal area of consolidation , pleural effusion , or pneumothorax . "
2471,2590_IM-1083-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2472,2591_IM-1083-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
2473,2592_IM-1084-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
2474,2593_IM-1084-1001.dcm.png,"mild cardiomegaly is unchanged . stable superior mediastinal contour which is within normal limits . bilateral interstitial prominence . no focal airspace consolidation , pleural effusion , or pneumothorax . no acute osseous abnormalities . "
2475,2594_IM-1085-1001.dcm.png,the heart size is normal . tortuous aorta . otherwise the mediastinal contour is within normal limits . low lung volumes . mild elevation of the right hemidiaphragm . there is streaky opacity within the right lower lobe . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2476,2595_IM-1086-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2477,2596_IM-1086-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2478,2597_IM-1087-1001.dcm.png,the mediastinal and hilar lymph are less prominent than previously . heart size remains normal . lungs are clear . 
2479,2599_IM-1089-1001.dcm.png,there is an irregular opacity projecting over the left apex . additionally there is a more inferior left upper lobe opacity measuring approximately 6 mm in diameter . no pneumothorax . no pleural effusions . heart size is normal limits . degenerative changes thoracic spine . 
2480,2600_IM-1091-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . note of placement of a retention in the lower cervical spine . 
2481,2601_IM-1092-4001.dcm.png,unknown
2482,2604_IM-1094-1001.dcm.png,unknown
2483,2605_IM-1095-1001.dcm.png,single view of chest was obtained in ap projection . limited study secondary to body habitus . the cardiomediastinal silhouette is not enlarged . lungs demonstrate no focal infiltrates . there is no effusion or pneumothorax . 
2484,2607_IM-1097-3003.dcm.png,unknown
2485,2608_IM-1098-2001.dcm.png,consolidation and costophrenic blunting persists in both lower lobes . heart and pulmonary remain normal . no infiltrates . 
2486,2609_IM-1099-3001.dcm.png,unknown
2487,2610_IM-1101-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . hyperexpanded lungs , without focal consolidation , pneumothorax or large pleural effusion . right upper lobe scarring/atelectasis . aortic calcifications . "
2488,2611_IM-1102-1001.dcm.png,no focal consolidation . no visualized pneumothorax . heart size is normal . cardiac and mediastinal silhouette is grossly unremarkable . 
2489,2611_IM-1102-3001.dcm.png,no focal consolidation . no visualized pneumothorax . heart size is normal . cardiac and mediastinal silhouette is grossly unremarkable . 
2490,2612_IM-1103-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2491,2613_IM-1104-1001.dcm.png,unknown
2492,2614_IM-1105-1001.dcm.png,"the heart size is within normal limits . prominent right paratracheal soft tissues representing adenopathy . no focal airspace consolidation , pleural effusions or pneumothorax . no acute bony abnormalities . "
2493,2615_IM-1106-1001.dcm.png,"moderate cardiomegaly . mild bilateral costophrenic blunting and fissural thickening , interstitial opacities greatest in the central lungs and bases with indistinct vascular margination . dense right lower lobe nodule and right hilar calcifications suggest a previous granulomatous process . "
2494,2616_IM-1106-1001.dcm.png,frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . the right costophrenic sulcus is blunted . there is an the right base xxxx/fluid level . the left lung is clear . 
2495,2617_IM-1106-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are hyperexpanded . no focal airspace disease . no large pleural effusion or pneumothorax . exaggerated kyphosis . 
2496,2618_IM-1107-2001.dcm.png,normal cardiomediastinal contours . no pneumothorax or large pleural effusions . small focal retrocardiac lung opacity . 
2497,2619_IM-1108-1001.dcm.png,unknown
2498,2620_IM-1109-1001.dcm.png,cardiac silhouette within normal limits . central pulmonary vasculature is not engorged . no pneumothorax or pleural effusion . visualized osseous structures are unremarkable . no edema or focal consolidation in the lungs . 
2499,2621_IM-1109-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2500,2622_IM-1110-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . tracheostomy tip approximately 5 cm above the carina . no pleural effusion or pneumothorax . 
2501,2623_IM-1111-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . no acute bony or soft tissue abnormality . "
2502,2624_IM-1111-1001.dcm.png,"heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . there is a mild anterior wedge deformity of l1 , age-indeterminate . "
2503,2625_IM-1112-0001-0002.dcm.png,heart size and pulmonary vasculature are normal . lungs are clear . no pneumothorax large effusion . no acute bony abnormality . 
2504,2626_IM-1113-2001.dcm.png,unknown
2505,2627_IM-1114-3001.dcm.png,postsurgical changes of the right chest . mild elevation of the right hemidiaphragm . lungs are clear without focal airspace disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
2506,2628_IM-1115-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . lungs are mildly hypoinflated with minimal streaky atelectasis or scar in the lung bases . lungs are otherwise grossly clear of focal airspace disease . there is a stable calcified granuloma in the posterior left midlung . there is no pneumothorax or pleural effusion . there are no acute bony findings . 
2507,2629_IM-1116-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
2508,2631_IM-1118-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . interval placement of right humeral prosthesis , incompletely evaluated . incompletely evaluated the lumbar spine fusion xxxx . cholecystectomy . "
2509,2632_IM-1119-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
2510,2633_IM-1120-2002.dcm.png,"heart size is normal . prior calcified granulomatous disease . on the lateral view in the anterior costophrenic xxxx , there is a 2 . 1 x 2 cm nodular density which seems to be present previously but is more nodular in appearance on this examination . no pleural effusion or pneumothorax . endplate degenerative changes of the thoracolumbar spine and mild scoliosis are unchanged . "
2511,2636_IM-1121-1001.dcm.png,sternotomy remain in xxxx . the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . minimal degenerative changes of the thoracic spine . 
2512,2637_IM-1122-4004.dcm.png,"moderate-to-marked enlargement of the cardiac silhouette , mediastinal contours appear similar to prior . mild bilateral posterior sulcus blunting , interstitial and alveolar opacities greatest in the central lungs and bases with indistinct vascular margination . "
2513,2638_IM-1123-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2514,2639_IM-1124-2001.dcm.png,"the cardiomediastinal silhouette is within normal limits of size and appearance . the pulmonary vascularity is unremarkable . lungs are expanded and clear of airspace disease . negative for pneumothorax or pleural effusion . there is mild midthoracic dextroscoliosis , with the otherwise grossly intact . "
2515,2640_IM-1126-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2516,2642_IM-1128-1001.dcm.png,unknown
2517,2643_IM-1129-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
2518,2644_IM-1130-1001.dcm.png,"mild cardiomegaly . pulmonary vasculature is within normal limits . costophrenic are xxxx . there is increased kyphotic curvature of the thoracic spine . within the heart xxxx , there is a small area of oval-shaped density measuring 2 . 2 x 1 . 6 cm without correction for magnification . there is a calcified lymph node in the right hilum . no pneumothorax . "
2519,2645_IM-1131-2001.dcm.png,"surgical clips within the right upper quadrant . lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2520,2646_IM-1131-1001.dcm.png,"no focal airspace disease , pleural effusion or pneumothorax . cardiomediastinal silhouette is within normal limits . there are prominent lateral osteophytes along the right aspect of the mid thoracic spine which are stable . no free subdiaphragmatic air . "
2521,2647_IM-1132-1001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax or large pleural effusion . foreign body in the posterior soft tissues appear stable . "
2522,2651_IM-1136-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
2523,2652_IM-1136-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette and mediastinal contours are not enlarged . there is calcified mediastinal lymph xxxx . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
2524,2653_IM-1137-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . mild degenerative changes of the thoracic spine . "
2525,2654_IM-1137-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2526,2655_IM-1137-1001.dcm.png,the cardiomediastinal silhouette is normal in size in appearance and stable from xxxx . the lungs are clear . soft tissues and bony structures are unremarkable . no pneumothorax or pleural effusion . 
2527,2657_IM-1139-0001-0002.dcm.png,unknown
2528,2658_IM-1140-1001.dcm.png,normal heart size and mediastinal contours . atherosclerotic calcifications of the thoracic aorta . no focal airspace opacity . no pleural effusion or pneumothorax . the visualized bony structures are unremarkable in appearance . 
2529,2659_IM-1140-1001.dcm.png,no focal lung consolidation . no pneumothorax or large pleural effusion . heart size and pulmonary vascularity are within normal limits . osseous structures are grossly intact . 
2530,2660_IM-1142-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2531,2661_IM-1142-1001.dcm.png,"mild cardiomegaly . low lung volumes without focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
2532,2662_IM-1143-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2533,2663_IM-1144-1001.dcm.png,the lungs are clear . no pleural effusion or pneumothorax is identified . the heart and mediastinum are normal . the skeletal structures and soft tissues are normal . 
2534,2664_IM-1145-1001.dcm.png,unknown
2535,2665_IM-1145-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
2536,2666_IM-1145-1001.dcm.png,unknown
2537,2667_IM-1146-1001.dcm.png,heart size normal . no focal airspace disease . no pneumothorax or effusions . no bony abnormalities . 
2538,2668_IM-1147-3001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2539,2669_IM-1147-1001.dcm.png,unknown
2540,2670_IM-1148-1001.dcm.png,"hyperexpanded lungs with flattened hemidiaphragms , consistent with emphysema . there is streaky airspace opacities in the left suprahilar and lingular regions . no pneumothorax or effusions . mild bilateral costophrenic blunting represents pleural thickening and scarring . degenerative changes of the thoracic spine . "
2541,2671_IM-1148-1001-0002.dcm.png,unknown
2542,2672_IM-1148-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
2543,2673_IM-1149-1001.dcm.png,"the heart is large . in the interval , pulmonary venous engorgement has developed . also , bibasilar interstitial infiltrates are present . "
2544,2674_IM-1149-1001.dcm.png,unknown
2545,2676_IM-1151-1001.dcm.png,"nasogastric tube tip within the stomach body , stable . low lung volumes . stable enlarged cardiomediastinal silhouette . atherosclerosis of the thoracic aorta . no focal consolidation , pneumothorax or large pleural effusion . relative elevation of right hemidiaphragm . stable obscuration of lateral left diaphragm . "
2546,2677_IM-1151-1001.dcm.png,"heart size normal . mild tortuosity of the thoracic aorta . there is no focal consolidation , pneumothorax , or pleural effusion identified . a bullet is noted in the soft tissues of the inferior right chest wall . no acute bony abnormality . "
2547,2679_IM-1153-1001.dcm.png,unknown
2548,2680_IM-1154-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
2549,2681_IM-1154-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a small stable foreign body noted over the left chest . there are vascular calcifications over the aortic xxxx . there are mild degenerative changes of the spine . "
2550,2683_IM-1156-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2551,2684_IM-1157-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . a calcified granuloma is identified in the peripheral aspect of the left lower lobe . calcified lymph are identified in left hilar region . no pneumothorax . no pleural effusion . minimal degenerative endplate changes of the thoracic spine . 
2552,2685_IM-1158-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . there is mild eventration of right hemidiaphragm . no pleural effusion is seen . 
2553,2686_IM-1158-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . 
2554,2687_IM-1158-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusions or pneumothorax . surgical clips overlying the left breast soft tissues . multilevel degenerative changes of the thoracic spine . no acute bony abnormalities . "
2555,2688_IM-1159-4004.dcm.png,"there is mild cardiomegaly . aorta is heavily calcified and tortuous , consistent with atherosclerotic disease . there are diffuse increased interstitial opacities identified . this may be secondary to edema , or alternatively atypical infection . no large effusion or visualized pneumothorax . osteopenia of the spine is identified . "
2556,2689_IM-1160-1002001.dcm.png,calcified granulomas are present . there is an area of focal density overlying the right first rib and medial clavicle . this is approximately 1 . 2 cm in diameter . it may be secondary to overlapping structures . lungs are otherwise clear . there is no pleural effusion or pneumothorax . the heart is normal . calcifications of the aortic are seen . the skeletal structures are unremarkable . there has been a left mastectomy . 
2557,2690_IM-1162-1003002.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a calcified granuloma within the left midlung . "
2558,2691_IM-1163-4004.dcm.png,unknown
2559,2692_IM-1164-1001.dcm.png,unknown
2560,2693_IM-1165-1001.dcm.png,there are low lung volumes . the cardiac silhouette and mediastinal contours are within normal limits . there is tortuosity of the thoracic aorta . no pneumothorax . no large pleural effusion . 
2561,2694_IM-1165-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
2562,2695_IM-1166-1001.dcm.png,the cardiac contours are normal . the lungs are hyperinflated with flattened diaphragms . no acute pulmonary findings . thoracic spondylosis . 
2563,2696_IM-1166-1001.dcm.png,apparent cardiomegaly at partially accentuated by low lung volumes . relative elevation right hemidiaphragm . streaky left retrocardiac densities . no pneumothorax or large pleural effusion . surgical clips near the gastroesophageal junction . negative for acute bone abnormality . 
2564,2697_IM-1167-1001.dcm.png,unknown
2565,2698_IM-1167-1001.dcm.png,the lungs appear clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
2566,2699_IM-1167-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . multiple punctate round over the abdomen on the lateral view . these may reside within , or outside of the patient . "
2567,2700_IM-1169-1001.dcm.png,cardiac and mediastinal contours are within normal limits . granulomatous calcifications and mediastinum . the lungs are clear . bony structures are intact . 
2568,2701_IM-1169-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2569,2702_IM-1170-1001.dcm.png,cardiomegaly . prominent are stable . low lung volumes . no pneumothorax . minimal right costophrenic blunting . no focal infiltrates . 
2570,2704_IM-1171-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . the aorta is unfolded . there is left base streaky opacity due to scarring or discoid atelectasis . there is a midright lung small calcified granuloma . there are small nodular opacities projecting over the right base in the right costophrenic sulcus , posterior right 9th rib and the anterior t10 vertebral body . no focal airspace consolidation or pleural effusion . "
2571,2705_IM-1171-1001.dcm.png,unknown
2572,2706_IM-1172-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart and mediastinum are normal . arthritic changes are seen throughout the spine and both xxxx . 
2573,2708_IM-1174-1001.dcm.png,"the cardiac and mediastinal contours are within normal limits . there are calcified mediastinal lymph xxxx , with a calcified right lower lobe pulmonary nodule . the lungs are well-inflated and clear . there is no focal consolidation , pneumothorax , or effusion . there are degenerative changes of the first costochondral joints bilaterally . no acute bony abnormalities are seen . "
2574,2709_IM-1175-1001.dcm.png,there is a subtle left medial base opacity . cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . 
2575,2710_IM-1177-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2576,2711_IM-1178-0001-0001.dcm.png,right chest central venous line is noted with tip in the mid svc . there is no pneumothorax . heart size is normal . no large pleural effusions . no acute focal airspace opacification . 
2577,2712_IM-1179-2001.dcm.png,unknown
2578,2713_IM-1180-1001.dcm.png,"the heart is normal in size and contour . the aorta is calcified and tortuous . the lung volumes are low . there is elevation of the right hemidiaphragm . minimal streaky opacities in the lung bases , subsegmental atelectasis . no pleural effusion or pneumothorax . "
2579,2714_IM-1180-1001.dcm.png,unknown
2580,2715_IM-1180-1001.dcm.png,"heart size and mediastinal contour are normal . pulmonary vascularity is normal . there is a 9 mm right lower lobe pulmonary nodule , not seen on prior exams . there are posttraumatic deformities of the right posterior ribs . no focal airspace consolidation or effusion . no pneumothorax . "
2581,2716_IM-1181-1001.dcm.png,within the right lower lobes there are airspace opacities representing consolidation and atelectasis with blunting of the bilateral costophrenic xxxx . the cardiomediastinal silhouette is within normal limits . bibasilar subsegmental atelectasis . no acute osseous abnormality . 
2582,2717_IM-1181-1001-0001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
2583,2718_IM-1182-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . there are mild degenerative changes along the thoracic spine . no acute bony abnormality is identified . 
2584,2719_IM-1182-1001.dcm.png,"heart size within normal limits . prominent interstitial and nodular opacities are increased since comparison exam . there is a 1 cm nodular opacity in the right costophrenic xxxx , increased since comparison examination . a cystic lesion in the right upper lobe appears similar to prior examination . no pleural effusion or pneumothorax . "
2585,2720_IM-1182-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2586,2721_IM-1183-1001.dcm.png,"heart size at the upper limits of normal . there are scattered calcified granulomas . no focal airspace consolidation , large effusion , or appreciable pneumothorax . tortuous , unfolded to descending aorta . calcified aortic xxxx . curvature of the thoracic spine . exaggerated kyphosis . are diffusely osteopenic . multilevel degenerative changes of the thoracic spine with minimal anterior loss of several vertebral bodies . "
2587,2722_IM-1184-1001.dcm.png,overall low lung volumes . lungs are grossly clear . pleural thickening along the inferior left lateral chest . this appears relatively stable compared to the prior examination . no pleural effusions or pneumothoraces . cardiomegaly . degenerative changes in the spine . 
2588,2723_IM-1185-1001.dcm.png,negative for cardiac enlargement or vascular congestion . minimal subsegmental atelectasis at the left base otherwise negative for focal confluent airspace disease . the visualized bony structures are intact . there are minimal degenerative disc changes of the mid/lower thoracic spine . no pneumothorax . 
2589,2724_IM-1186-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart size is normal . there is some tortuosity of the aorta . degenerative changes in the thoracic spine
2590,2725_IM-1186-1001.dcm.png,cardiac and mediastinal contours are within normal limits . emphysematous changes are present . the lungs are free of active disease . deformed right ribs . thoracic spondylosis . 
2591,2726_IM-1186-2001.dcm.png,the heart is normal in size . the mediastinum is within normal limits . the study is somewhat limited . no focal consolidation is seen . 
2592,2727_IM-1187-1001.dcm.png,"heart size is normal . cardiomediastinal silhouette stable . no pneumothorax , pleural effusion , or focal airspace disease . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . emphysema . "
2593,2727_IM-1187-1002.dcm.png,"heart size is normal . cardiomediastinal silhouette stable . no pneumothorax , pleural effusion , or focal airspace disease . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . emphysema . "
2594,2728_IM-1187-1001.dcm.png,lungs remain hyperexpanded . no change in the right middle lobe opacification . no infiltrates or masses . pulmonary arteries are prominent centrally . 
2595,2729_IM-1187-1001.dcm.png,"normal heart size , mediastinal and aortic contours . normal pulmonary vascularity . elevated left hemidiaphragm with scarring at the left costophrenic xxxx . there is a bullet fragment overlying the left t7 vertebra . retained bullet fragments noted within the left upper and lower lobes . no focal consolidation , visible pneumothorax or large pleural effusion . mild degenerative changes of the thoracic spine . "
2596,2730_IM-1189-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
2597,2731_IM-1189-1001.dcm.png,unknown
2598,2733_IM-1189-1001.dcm.png,"bibasilar airspace opacities , right greater than left . the heart size and mediastinal silhouette are within normal limits for contour . no pneumothorax or pleural effusions . the are intact . "
2599,2734_IM-1189-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2600,2735_IM-1189-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2601,2737_IM-1191-4004.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there is slight elevation of left hemidiaphragm with left basilar subsegmental atelectasis . the lungs are otherwise grossly clear . 
2602,2738_IM-1192-1001.dcm.png,the heart size is upper limits of normal . aorta is tortuous . the lungs are clear without focal infiltrate . no pleural effusion or pneumothorax . 
2603,2739_IM-1193-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . 
2604,2740_IM-1195-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . lateral view reveals degenerative changes of the thoracic spine . "
2605,2741_IM-1196-1001.dcm.png,unknown
2606,2742_IM-1197-1001.dcm.png,the cardiac contours are normal . prior granulomatous disease . the lungs are clear . thoracic spondylosis . lower cervical degenerative arthritis . 
2607,2743_IM-1197-1001.dcm.png,"there are no acute osseous abnormalities . degenerative changes throughout the thoracic spine . normal heart size . calcific aorta . normal vascular markings . no focal area of consolidation , pleural effusion , or pneumothorax . "
2608,2744_IM-1197-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2609,2745_IM-1197-12012.dcm.png,normal heart size and mediastinal contours . clear lungs besides scattered calcified granulomas . no pneumothorax or pleural effusion . no acute bony abnormalities . 
2610,2746_IM-1198-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . right chest is visualized with tip at cavoatrial junction . there is no pneumothorax . the lungs are clear . 
2611,2747_IM-1198-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . small pleural effusion is identified . 
2612,2748_IM-1198-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no suspicious pulmonary mass or nodule is identified . there is no pleural effusion or pneumothorax . heart size and mediastinal contour are within normal limits . 
2613,2749_IM-1199-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . there is no pleural effusion or pneumothorax . old right-sided rib deformities are noted . 
2614,2750_IM-1200-1001.dcm.png,unknown
2615,2751_IM-1201-1001.dcm.png,the cardiopulmonary silhouette is normal . the heart size is normal . the lungs are clear with no pulmonary effusions or pneumothorax . 
2616,2752_IM-1202-0001-0001.dcm.png,"the cardiac silhouette is mildly enlarged . mediastinal contours are within normal limits . the pulmonary vasculaturity is increased . there is large right-sided pleural effusion and probable underlying associated compressive atelectasis . mild perihilar opacities , edema . no pneumothorax is seen . "
2617,2753_IM-1203-1001.dcm.png,"stable calcified superior mediastinal lymph xxxx . lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2618,2754_IM-1204-2002.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
2619,2755_IM-1204-1001.dcm.png,"cardiomediastinal silhouette is unchanged with mild cardiomegaly . there is relative elevation of the right hemidiaphragm consistent with history of right lower lobectomy , without focal consolidation , pneumothorax , or effusion identified . irregularity of the right fifth and sixth ribs stable since at and postsurgical/post traumatic in xxxx . left shoulder rotator bone anchor noted . no acute osseous abnormality identified . "
2620,2756_IM-1205-1001.dcm.png,"right lower lobe infiltrate . the trachea is midline . negative for pneumothorax , pleural effusion . the heart size is normal . there has been interval placement of a left chest xxxx , with its distal tip in the left sided svc"
2621,2758_IM-1206-1001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
2622,2759_IM-1207-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . no focal air is prominent consolidation . no pneumothorax . no large pleural effusion . minimal degenerative changes of the thoracic spine with a mild wedge deformity of a midthoracic vertebral body . this is age-indeterminate . 
2623,2760_IM-1207-1001.dcm.png,there is minimal scarring within the left lung base . the lungs are otherwise clear . heart size is normal . no pneumothorax . 
2624,2761_IM-1208-1001.dcm.png,"stable , normal cardiac size , mediastinum , and central pulmonary vasculature . interval development of mild patchy airspace opacities within the posterior aspect of the right upper lobe , concerning for underlying pneumonia . stable mild background chronic interstitial changes . no evidence of associated pleural effusion or pneumothorax . multilevel midthoracic degenerative changes , with prominent anterolateral marginal osteophytes . "
2625,2762_IM-1208-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . there is evidence of granulomatous disease . "
2626,2763_IM-1209-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . there is mild prominence of the interstitial markings which are unchanged . 
2627,2764_IM-1209-1001.dcm.png,unknown
2628,2765_IM-1210-1001.dcm.png,unknown
2629,2766_IM-1211-4004.dcm.png,unknown
2630,2767_IM-1212-1001.dcm.png,lungs are clear . no pleural effusion or pneumothorax . cardiomediastinal silhouette is normal . there are minimal degenerative changes of the spine . 
2631,2768_IM-1212-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
2632,2769_IM-1212-1001.dcm.png,"cardiomediastinal silhouette are normal in size and contour . again demonstrated are biapical bullous emphysematous changes . no focal consolidation , pneumothorax , or pleural effusion . mild multilevel degenerative changes of the thoracic spine . "
2633,2770_IM-1213-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
2634,2771_IM-1213-1001.dcm.png,chest . both lungs clear and expanded . heart and mediastinum normal . ankle . soft tissue is present around the malleoli . intact . mortise radiographically stable . 
2635,2772_IM-1213-1001.dcm.png,unknown
2636,2773_IM-1214-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . mild degenerative changes at the lower thoracic spine . "
2637,2774_IM-1215-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size is mildly enlarged , pulmonary vascularity within normal limits . "
2638,2775_IM-1216-3001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2639,2776_IM-1217-1001.dcm.png,unknown
2640,2777_IM-1217-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . no pneumothorax , pleural effusion , or focal air space consolidation . minimal scarring or atelectasis left lung base . "
2641,2778_IM-1218-1001.dcm.png,the pulmonary nodules and masses masses on previous exam are smaller and not definitely seen . the lungs are otherwise clear . heart size normal . no pneumothorax . there is a right chest with tip projecting over the lower svc . 
2642,2779_IM-1218-1001.dcm.png,unknown
2643,2780_IM-1218-1002.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2644,2781_IM-1219-1001.dcm.png,normal heart . clear lungs . no pneumothorax . no pleural effusion . trachea is midline . 
2645,2782_IM-1220-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2646,2783_IM-1220-1001.dcm.png,no interval change is found in the bony thorax . the heart size remains normal with an ectatic tortuous aorta . the pulmonary vasculature is not engorged . lungs are free of infiltrate and there is no pleural effusion . the fullness to the right hilum is again noted but this is unchanged suggesting no progression of the retrohilar nodule on the ct scan . no pulmonary nodule is found . 
2647,2784_IM-1220-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
2648,2785_IM-1220-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2649,2786_IM-1221-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2650,2787_IM-1222-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size is upper limits of normal . pulmonary vasculature appear within normal limits . are intact . "
2651,2788_IM-1222-1001.dcm.png,there is no focal consolidation . there is no pneumothorax or large pleural effusion . the cardiomediastinal contours are grossly unremarkable . the heart size is within normal limits . 
2652,2789_IM-1223-8001.dcm.png,"heart size near top normal limits , mild aortic ectasia size tortuosity . mediastinal calcifications and dense nodule in the lingula suggest a previous granulomatous process . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2653,2790_IM-1224-1001.dcm.png,"normal and stable cardiomediastinal contours . no pneumothorax , pleural effusions or significant pulmonary edema . no focal lung consolidation . stable mild interstitial prominence and bilateral lung bases . "
2654,2791_IM-1225-2001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2655,2792_IM-1226-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
2656,2793_IM-1226-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . hyperexpanded lungs without focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
2657,2794_IM-1226-1001.dcm.png,lungs are hyperexpanded . no infiltrates or masses in the lungs . heart size normal . 
2658,2795_IM-1227-1001.dcm.png,cardiomediastinal silhouettes are within normal limits . the there is a diffuse reticulonodular pattern the lungs bilaterally . pulmonary vasculature is within normal limits . negative for pneumothorax or large pleural effusion . bony thorax is unremarkable
2659,2796_IM-1228-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2660,2796_IM-1228-12012.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2661,2797_IM-1229-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . "
2662,2798_IM-1230-3001.dcm.png,unknown
2663,2799_IM-1231-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2664,2801_IM-1233-3003.dcm.png,unknown
2665,2802_IM-1234-1001.dcm.png,"hyperexpanded lungs . lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . multiple surgical clips overlie the midabdomen . "
2666,2803_IM-1234-1001.dcm.png,"there are low lung volumes . the cardiac silhouette , upper mediastinum pulmonary vasculature are within normal limits . there is no acute pulmonary consolidation , pleural effusion or pneumothorax . "
2667,2804_IM-1235-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no nodules or adenopathy is identified . 
2668,2805_IM-1235-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2669,2806_IM-1236-1001.dcm.png,heart size is normal lungs are clear . no edema or effusions . 
2670,2807_IM-1237-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . "
2671,2808_IM-1238-1001.dcm.png,sequelae of old granulomatous disease . lungs are clear without focal consolidation . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
2672,2809_IM-1238-1001.dcm.png,unknown
2673,2810_IM-1238-1001.dcm.png,"heart size and cardiomediastinal contours are normal . aorta is mildly tortuous . lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . mild degenerative changes in the spine . "
2674,2811_IM-1238-2001.dcm.png,unknown
2675,2812_IM-1239-2001.dcm.png,"lung volumes are low . in the interval , a patchy infiltrate has developed in the right lower lobe . heart and pulmonary are normal . "
2676,2813_IM-1239-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or effusion . mild degenerative change in the thoracic spine . 
2677,2814_IM-1239-1001.dcm.png,unknown
2678,2815_IM-1240-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . granulomatous sequela are noted . the lungs are otherwise clear . 
2679,2817_IM-1241-1001.dcm.png,"evaluation is limited due to obscuration by the patient's arm on the lateral view . cardiomediastinal silhouette is within normal limits of size and appearance . pulmonary vascular is unremarkable . are chronic , coarse interstitial lung markings . peripheral opacity along the right mid lung reflects scar or a small amount of loculated pleural fluid or thickening . otherwise negative for focal airspace disease or consolidation . hyperlucent lungs with apical xxxx . negative for pneumothorax or pleural effusion . limited evaluation reveals the to be grossly intact . "
2680,2817_IM-1241-3001.dcm.png,"evaluation is limited due to obscuration by the patient's arm on the lateral view . cardiomediastinal silhouette is within normal limits of size and appearance . pulmonary vascular is unremarkable . are chronic , coarse interstitial lung markings . peripheral opacity along the right mid lung reflects scar or a small amount of loculated pleural fluid or thickening . otherwise negative for focal airspace disease or consolidation . hyperlucent lungs with apical xxxx . negative for pneumothorax or pleural effusion . limited evaluation reveals the to be grossly intact . "
2681,2818_IM-1242-1001.dcm.png,"there is stable cavity in the right apex , related to prior tuberculosis infection . there is increased opacity in the left upper lobe , peripherally . there is pulmonary hyperexpansion . there is no large effusion or pneumothorax . "
2682,2819_IM-1243-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum unremarkable . no change in the mediastinal surgical clips . 
2683,2820_IM-1244-1001.dcm.png,pa and lateral views of the chest were obtained . the heart is normal in size . mediastinal contours are within normal limits . the lungs are clear . there is no pleural effusion or pneumothorax . 
2684,2821_IM-1244-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . aortic calcifications and tortuosity . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . degenerative changes of the thoracic spine . 
2685,2822_IM-1244-2002.dcm.png,"no focal consolidation , effusion , or pneumothorax . normal heart size . stable left subclavian chest catheter tip in mid svc . lungs are well expanded . calcified granuloma posteriorly in the medial right lower lobe . postsurgical changes of anterior lower cervical spine fusion . thoracic spine demonstrates mild degenerative changes with some mild loss of t4 and t7 vertebral bodies . "
2686,2824_IM-1245-13001.dcm.png,"the lungs and pleural spaces show no acute abnormality . hyperexpanded lungs . calcified right upper lobe granuloma , unchanged . heart size and pulmonary vascularity within normal limits . no displaced rib fractures . "
2687,2826_IM-1246-1001.dcm.png,prominent interstitial markings in the lungs are unchanged . no focal infiltrates . heart and pulmonary are normal . 
2688,2827_IM-1246-1001.dcm.png,"there is an endotracheal tube at the level of the carina , recommend retraction . heart size is normal . the mediastinal silhouette is unremarkable . shrapnel is overlying the right lower lobe . there is a round bullet overlying the t10 vertebral body . density is seen within the right lower lobe representing hemorrhage . there is a right-sided pneumothorax with 10 mm in maximal thickness . there is right axillary subcutaneous emphysema . probable lateral right 8th rib fracture . the osseous structures are otherwise normal . "
2689,2828_IM-1247-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are hyperexpanded but clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
2690,2829_IM-1247-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
2691,2829_IM-1247-3001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
2692,2830_IM-1248-1001.dcm.png,unknown
2693,2831_IM-1249-1001.dcm.png,unknown
2694,2832_IM-1249-1001.dcm.png,"there is stable cardiomegaly . the mediastinum is unremarkable . atherosclerotic calcifications are present within the thoracic aorta . there is no pleural effusion , pneumothorax , or focal airspace disease . chronic degenerative changes are present in the thoracic spine . "
2695,2833_IM-1249-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . both clavicles appear within normal limits on this limited radiographic evaluation . "
2696,2835_IM-1251-1001.dcm.png,heart size is within normal limits . low lung volumes . no focal airspace consolidations . no pneumothorax or pleural effusion . 
2697,2835_IM-1251-3001.dcm.png,heart size is within normal limits . low lung volumes . no focal airspace consolidations . no pneumothorax or pleural effusion . 
2698,2836_IM-1252-1001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show reduced lung volumes with bronchovascular crowding of basilar atelectasis . no definite focal airspace consolidation or pleural effusion . the cardiac silhouette appears mildly enlarged . 
2699,2837_IM-1252-1001.dcm.png,"rounded 1 . 4 cm projecting retrosternally on lateral view only . no focal consolidation , effusion , or pneumothorax . normal heart size . minimal degenerative changes of the thoracic spine . negative for pneumoperitoneum . "
2700,2838_IM-1252-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
2701,2839_IM-1252-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2702,2840_IM-1253-1001-0002.dcm.png,this study is limited by the patient body habitus . lungs appear to be clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
2703,2842_IM-1254-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2704,2843_IM-1254-1001-0002.dcm.png,the heart is normal in size . there is right paratracheal density concerning for lymphadenopathy . there are patchy right upper lobe streaky opacities . the remainder of the lungs are clear . there is no pleural effusion . 
2705,2844_IM-1254-1001.dcm.png,normal heart size and mediastinal contours . the lungs are clear . there is no pneumothorax or pleural effusion . left shoulder arthroplasty is noted . old left rib fractures . 
2706,2845_IM-1254-1001.dcm.png,lungs are clear . heart size normal . the are unremarkable . 
2707,2847_IM-1256-1001.dcm.png,"the heart size is within normal limits . the thoracic aorta is tortuous , stable from the prior radiograph . aortic stent graft overlies the descending thoracic aorta and upper abdominal aorta , grossly stable from the prior chest radiograph . there are scattered calcified granulomas . there is no focal airspace consolidation . no pleural effusion or pneumothorax . the left hemidiaphragm remains mildly elevated . there are mild degenerative changes of the spine . "
2708,2848_IM-1256-1001.dcm.png,mild cardiomegaly . lungs are clear . calcified hilar xxxx . no pleural effusion or pneumothorax . soft tissues and showed unremarkable . 
2709,2850_IM-1259-2002.dcm.png,unknown
2710,2851_IM-1260-0001-0001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2711,2852_IM-1261-3001.dcm.png,normal cardiac contours . no pleural effusion or pneumothorax . no acute bony abnormalities . clear lung bilaterally . no intervertebral disc narrowing or loss of vertebral body xxxx . 
2712,2854_IM-1262-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2713,2855_IM-1263-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2714,2856_IM-1263-1001.dcm.png,"normal heart size . no focal airspace consolidation , pneumothorax , pleural effusion , or pulmonary edema . no focal bony abnormality . "
2715,2857_IM-1264-1001.dcm.png,there are sternotomy and mediastinal surgical clips secondary to a cabg procedure . small t-spine osteophytes . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are cholecystectomy clips . there is eventration of right hemidiaphragm . 
2716,2858_IM-1265-1001.dcm.png,heart size normal . tortuous aorta . sequela primary granulomatous disease . lungs clear . minimal spurring in the thoracic spine . 
2717,2858_IM-1265-3001.dcm.png,heart size normal . tortuous aorta . sequela primary granulomatous disease . lungs clear . minimal spurring in the thoracic spine . 
2718,2859_IM-1266-1001.dcm.png,there is a rounded dense opacity in the lateral left midlung zone probably the left upper lobe most suggestive of a rounded pneumonia . there is no pleural effusion . the heart and mediastinum are normal . the skeletal structures are normal . 
2719,2860_IM-1268-1001.dcm.png,"no acute osseous abnormality . scattered degenerative changes of the thoracic spine . surgical clips overlying the right upper quadrant . anterior cervical fusion xxxx . tortuous and ectatic aorta . no focal area of consolidation , pleural effusion , or pneumothorax . "
2720,2861_IM-1269-2001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2721,2862_IM-1270-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2722,2863_IM-1271-3001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2723,2864_IM-1272-1001.dcm.png,unknown
2724,2865_IM-1273-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . closure device demonstrated projecting over the right heart . there are no acute bony findings . "
2725,2866_IM-1273-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2726,2867_IM-1274-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the superior thoracic spine is again noted , unchanged from prior . lucent pulmonary parenchyma is consistent appearance with emphysema and appears unchanged from prior examinations . no evidence of pneumothorax . no focal airspace disease or pleural effusion . vague density in the medial right lung apex most representing overlying shadows of bony structures , which is stable . "
2727,2868_IM-1275-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , large pleural effusion , or pneumothorax is identified . minimal thoracic spondylosis . "
2728,2870_IM-1276-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
2729,2871_IM-1277-1001.dcm.png,the heart size is upper limits of normal . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . 
2730,2873_IM-1279-2002.dcm.png,heart size and vascularity normal . external contour normal . lungs clear . no pleural effusions or pneumothoraces . 
2731,2874_IM-1280-1001.dcm.png,the lungs appear clear . there is a calcified granuloma in the right lung base and calcified right hilar lymph xxxx . this was seen well on prior xxxx . there are no suspicious appearing pulmonary nodules or masses . heart and pulmonary appear normal . the pleural spaces are clear . mediastinal contours are normal . 
2732,2876_IM-1282-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . 
2733,2877_IM-1283-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
2734,2879_IM-1284-1001.dcm.png,borderline heart size . tortuous calcified aorta . no active pulmonary disease . mild spondylosis . 
2735,2880_IM-1284-1001.dcm.png,heart and mediastinal contour normal . pulmonary vascularity normal . lungs clear . no pleural effusions or pneumothoraces . 
2736,2881_IM-1285-4004.dcm.png,unknown
2737,2882_IM-1286-1001.dcm.png,there are no focal areas of consolidation . no suspicious bony opacities . heart size slightly enlarged . no pleural effusions . there is no evidence of pneumothorax . degenerative changes of the thoracic spine . 
2738,2884_IM-1286-1001.dcm.png,"the postoperative cardiomediastinal silhouette is stable and upper limits of normal in size . there are sternotomy and surgical clips compatible with prior cabg . there is at one left-sided coronary artery stent . pulmonary vasculature is normal in caliber . the lungs are grossly clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2739,2885_IM-1287-2001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . there is an obliquely oriented lucency through the posterior right 12th rib . "
2740,2886_IM-1288-0001-0002.dcm.png,low lung volumes . question patchy opacity left base . no pneumothorax . osseous structures intact . small right effusion . 
2741,2887_IM-1289-4001.dcm.png,the cardiomediastinal silhouette is normal in size and contour . there are a few opacities in the lung bases bilaterally . no definitive pneumothorax or pleural effusion . displaced fracture of the mid one-third of the right clavicle . 
2742,2888_IM-1290-0001-0001.dcm.png,heart size and pulmonary vascularity appear within normal limits . descending thoracic aorta is tortuous . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . 
2743,2889_IM-1291-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2744,2890_IM-1293-8001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . no definite pneumothorax . no displaced fracture . small rounded radiopaque density within the posterior superficial subcutaneous fat represents projectile fragment . . 
2745,2891_IM-1294-1001.dcm.png,"both lungs remain clear and expanded . no focal parenchymal infiltrates or pleural air collections . heart and aorta are normal . no change in the large hiatus hernia . pelvis . bone density is decreased . hips are normal and symmetric . no fractures , dislocations , or bone destruction . note of a severe rotatory dextroscoliosis in the lumbar spine . "
2746,2892_IM-1295-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there are calcified granulomas within the left lower lobe . there is no pneumothorax or effusion . "
2747,2893_IM-1295-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
2748,2894_IM-1296-4001-0001.dcm.png,the tracheostomy tube is in stable position . right subclavian catheter tip is in the lower svc . the left upper extremity picc tip is in the mid svc . surgical overlie the soft tissues of the neck . the lungs are clear . heart size is normal . no pneumothorax . 
2749,2895_IM-1297-1001.dcm.png,unknown
2750,2897_IM-1299-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
2751,2898_IM-1300-0001-0001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2752,2898_IM-1300-0001-0002.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
2753,2899_IM-1301-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2754,2901_IM-1305-1001.dcm.png,unknown
2755,2902_IM-1306-4001.dcm.png,"the cardiac silhouette , upper mediastinum and pulmonary vasculature are within normal limits . there is no acute air space infiltrate , pleural effusion or pneumothorax . the visualized osseous structures are intact . "
2756,2903_IM-1307-4004.dcm.png,"cardiac silhouette is within normal limits in size for ap technique . lungs are mildly hypoinflated but grossly clear of focal airspace disease , pneumothorax , or pleural effusion . pulmonary vasculature is normal in caliber . there are no acute bony findings . "
2757,2904_IM-1308-1001.dcm.png,stable cardiomediastinal silhouette with borderline heart size and aortic ectasia/tortuosity . stable hyperinflation without focal alveolar consolidation . no definite pleural effusion seen . no typical findings of pulmonary edema . healed left rib fractures again noted . 
2758,2905_IM-1309-1001.dcm.png,unknown
2759,2906_IM-1310-1001.dcm.png,unknown
2760,2908_IM-1312-4004.dcm.png,"heart size is upper limits of normal but stable . mediastinal contours are within normal limits . . chronically increased interstitial markings without focal airspace consolidation , pleural effusion , pneumothorax . degenerative changes of the spine . "
2761,2909_IM-1313-1001.dcm.png,patchy airspace disease in the left lingula . no significant effusion . clear right lung . normal heart size . granulomatous mediastinal calcifications . right chest tip at svc . 
2762,2910_IM-1314-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2763,2911_IM-1314-1001.dcm.png,unknown
2764,2915_IM-1317-3001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2765,2916_IM-1318-1001.dcm.png,"heart size within normal limits . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
2766,2917_IM-1319-1001.dcm.png,lungs are hyperexpanded . bullae are present in the upper lobes . no focal infiltrates or masses in the lungs . heart size normal . 
2767,2918_IM-1320-1001.dcm.png,"cardiomediastinal silhouette is normal . pulmonary vasculature and are normal . no consolidation , pneumothorax or large pleural effusion . osseous structures and soft tissues are normal . "
2768,2919_IM-1321-3001.dcm.png,"the heart is significantly enlarged . prominent pulmonary vascularity . no focal airspace consolidation , suspicious pulmonary opacity , or definite pleural effusion . no pneumothorax . visualized osseous structures appear intact . "
2769,2920_IM-1323-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart and mediastinum are normal . the skeletal structures and soft tissues are normal . 
2770,2922_IM-1325-12012.dcm.png,"hyperinflated lungs with flattened diaphragm and increased retrosternal airspace . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . heart size within normal limits . right hilar calcification suggests a previous granulomatous process . "
2771,2923_IM-1326-1001.dcm.png,clear lungs . heart and pulmonary appear normal . pleural spaces are clear . mediastinal contours are normal . 
2772,2924_IM-1327-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there is a small calcified granuloma within the left upper lobe . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2773,2925_IM-1327-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
2774,2926_IM-1328-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2775,2927_IM-1329-1001.dcm.png,unknown
2776,2928_IM-1330-13013.dcm.png,"mediastinum is stable . retrocardiac lucency represents a large hiatal hernia , unchanged from prior . the lungs are clear , without focal infiltrate or pleural effusion . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . stable thoracic deformity . "
2777,2929_IM-1331-2001.dcm.png,the heart is top normal in size . the mediastinum is unremarkable . the lungs are hypoinflated but grossly clear . significant degenerative changes of the are again noted bilaterally . 
2778,2930_IM-1333-1002001.dcm.png,there are t-spine osteophytes . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
2779,2931_IM-1334-1001.dcm.png,"the trachea is midline . the heart size is normal . opacities are seen in the left lower lobe and left costodiaphragmatic xxxx , which could represent scarring or atelectasis . there is no pneumothorax . no acute bony abnormalities . "
2780,2932_IM-1335-1001.dcm.png,the trachea is midline . the cardiomediastinal silhouette is normal in contour and unchanged in comparison to prior exams . the lungs are clear with no evidence of acute infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . 
2781,2933_IM-1336-1001.dcm.png,"normal heart size . no focal air space consolidation , pneumothorax , pleural effusion , or pulmonary edema . no focal bony abnormality . "
2782,2933_IM-1336-3001.dcm.png,"normal heart size . no focal air space consolidation , pneumothorax , pleural effusion , or pulmonary edema . no focal bony abnormality . "
2783,2934_IM-1337-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are mildly hyperlucent but clear . there is denser lumbar scoliosis . 
2784,2935_IM-1337-1001.dcm.png,"scoliosis and focal eventration of the posterior left hemidiaphragm . no focal alveolar consolidation . rotated position , considering technical factors heart size within normal limits . no definite pleural effusion seen , left bronchovascular crowding without typical findings of pulmonary edema . exaggerated kyphosis with increased ap dimension of the thorax . "
2785,2936_IM-1338-1002001.dcm.png,the heart size is mildly enlarged . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a moderate sized hiatal hernia . there mild degenerative changes of the spine . 
2786,2937_IM-1339-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
2787,2938_IM-1339-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
2788,2939_IM-1339-1001.dcm.png,"there are no acute osseous abnormalities . there are surgical clips in the right upper abdomen , from cholecystectomy . normal heart size . normal hilar vascular markings . the lungs are grossly clear without focal area of consolidation , pleural effusion , pneumothorax . "
2789,2940_IM-1341-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
2790,2941_IM-1342-1001.dcm.png,"cardiac and mediastinal contours are unremarkable . pulmonary vascularity is within normal limits . no focal air space opacities , pleural effusion , or pneumothorax . are grossly unremarkable . "
2791,2942_IM-1343-1001.dcm.png,"postsurgical changes of sternotomy with screw fixation of anterior plates . heart size and cardiomediastinal silhouette are normal . no focal consolidation , suspicious bony opacity , pneumothorax , or pleural effusion . no acute osseous abnormality . "
2792,2943_IM-1343-4004.dcm.png,unknown
2793,2944_IM-1344-1001.dcm.png,unknown
2794,2945_IM-1345-12012.dcm.png,"diffuse bilateral coarse interstitial markings are unchanged . no focal consolidation , pleural effusion , pneumothoraces . cardiomediastinal silhouette is within normal limits . degenerative changes of the shoulder . soft tissues are unremarkable . . "
2795,2946_IM-1346-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . lungs are clear of focal airspace disease . there is no pneumothorax . there is mild blunting of the right costophrenic xxxx , without definite pleural effusion . "
2796,2947_IM-1347-1001.dcm.png,unknown
2797,2948_IM-1348-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2798,2949_IM-1348-1001.dcm.png,"scattered calcified pulmonary nodules , represents calcified granulomas . lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . stable calcified hilar and mediastinal lymph xxxx , decreased in size from prior exam . heart size is normal . are unremarkable . "
2799,2950_IM-1348-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2800,2951_IM-1349-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . no pleural air collections . heart and mediastinum normal . a vague lucency is present in left rib 7 anteriorly . 
2801,2953_IM-1351-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
2802,2954_IM-1352-2001.dcm.png,"there is obscuration of the bilateral lung bases with lower lung volumes compared to prior examination . stable atelectatic/fibrotic changes of the visualized lung , and stable left-sided calcified granuloma . no acute osseous abnormalities identified . cardiomediastinal silhouette unremarkable . "
2803,2955_IM-1352-4004.dcm.png,unknown
2804,2956_IM-1353-2001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
2805,2957_IM-1354-1003.dcm.png,the heart is mildly enlarged . pulmonary vascularity is increased . there is again mild elevation of the right hemidiaphragm . air space disease and/or atelectasis is noted in right lung base . there is also streaky opacity in the left base . the costophrenic are blunted . 
2806,2958_IM-1354-1001.dcm.png,unknown
2807,2959_IM-1354-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2808,2960_IM-1354-1001.dcm.png,normal cardiac contours . clear lung bilaterally . no pneumothorax or pleural effusion . 
2809,2961_IM-1355-1001.dcm.png,there is patchy opacity in the left base concerning for atelectasis versus pneumonitis . there is a curvilinear lucency that appears to be in the right hemidiaphragm and a small amount of free intraperitoneal air may be present . there is a small left pleural effusion . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
2810,2962_IM-1355-1001.dcm.png,stable mild thoracic levoscoliosis . stable cardiomegaly . multiple scattered round calcific densities represent old granulomatous disease . no pneumothorax or pleural effusion . no focal consolidation . moderate degenerative changes of the thoracic spine . 
2811,2963_IM-1356-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
2812,2964_IM-1357-2001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . heart size and mediastinal contour are normal . 
2813,2965_IM-1358-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pleural effusion . no pneumothorax . 
2814,2966_IM-1359-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . scoliosis and degenerative changes are present in the spine . 
2815,2967_IM-1360-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2816,2968_IM-1360-1001.dcm.png,right paratracheal stripe is denser and than normal . the are normal . heart size normal . lungs clear and expanded with no infiltrates . 
2817,2969_IM-1360-1001.dcm.png,"heart size and mediastinal contours are stable . atherosclerotic calcifications of the aorta . moderate severe hyperexpansion of the lungs and decreased peripheral vascular markings , consistent with emphysema . stable biapical pleural-parenchymal scarring . scattered granulomas . no abnormal airspace consolidation . no pneumothorax or pleural effusion . "
2818,2970_IM-1362-1001.dcm.png,heart size and mediastinal contours are stable . stable calcification of the thoracic aorta . pulmonary vasculature is within normal limits . there is no focal air space opacity . no pleural effusion or pneumothorax is seen . no acute bony abnormality is demonstrated . 
2819,2971_IM-1362-2001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
2820,2972_IM-1363-1001.dcm.png,"the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated . costophrenic are blunted , corresponding to small bilateral pleural effusions . there is no focal consolidation or pneumothorax . "
2821,2974_IM-1364-1001.dcm.png,postsurgical changes are noted in the mediastinum . there is tortuosity and/or ectasia of the thoracic and upper abdominal aorta . no consolidative airspace opacities . blunting of the lateral and posterior left costophrenic sulcus may represent residual postsurgical effusion or pleural-parenchymal scarring . no demonstrable pneumothorax . cardiomediastinal silhouette within normal limits . multilevel anterior osteophytes of the thoracic spine . 
2822,2975_IM-1364-1001.dcm.png,unknown
2823,2976_IM-1365-2002.dcm.png,heart size and vascularity normal . lungs are hyperexpanded but clear . mediastinal contour normal . no pleural effusions or pneumothoraces . 
2824,2977_IM-1366-1001.dcm.png,unknown
2825,2978_IM-1367-4001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size and contour . there is a xxxx-a-xxxx terminating at the caval atrial junction , without evidence of pneumothorax . there is no focal airspace disease . there are small calcified nodules in the superior segment of the right lower lobe , old granulomatous infection . there are no acute bony findings . "
2826,2979_IM-1368-1001-0001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are calcified mediastinal lymph xxxx . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
2827,2980_IM-1370-1002001.dcm.png,negative for cardiac enlargement . negative for vascular congestion . negative for focal confluent airspace disease . negative for pneumothorax . a few scattered calcified granulomas are identified . 
2828,2981_IM-1371-1001.dcm.png,"normal heart size and mediastinal contours . no focal airspace consolidation . no pneumothorax or pleural effusion . mild dextro curvature of the lower thoracic spine , this may be positional . visualized bony structures are otherwise unremarkable . "
2829,2982_IM-1371-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . scarring is noted in the lingula . the lungs are clear . 
2830,2983_IM-1371-2001.dcm.png,cardiomediastinal silhouette is within normal limits . no focal consolidation . there is right lower lobe scarring . no pneumothorax or large pleural effusion . granulomas present . no acute bony abnormalities . 
2831,2984_IM-1372-1001.dcm.png,frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . there is a ap duct is calcified lymph node . the aorta is unfolded . cardiac silhouette remains moderately enlarged . low lung volumes due to exaggerated kyphosis . no focal airspace consolidation or pleural effusion . spine spondylosis . 
2832,2985_IM-1373-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax demonstrate stable , mild multilevel thoracolumbar degenerative disc disease without acute abnormality . upper abdominal midline surgical sutures are likewise stable . "
2833,2986_IM-1374-1001.dcm.png,"the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . mild dextro curvature of the thoracic spine , possibly positional . "
2834,2986_IM-1374-3001.dcm.png,"the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . mild dextro curvature of the thoracic spine , possibly positional . "
2835,2988_IM-1375-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
2836,2989_IM-1376-1001.dcm.png,"mediastinal contours are within normal limits . heart size is within normal limits . no focal consolidation , pneumothorax or pleural effusion . cervical fusion xxxx . degenerative changes of the spine and the acromioclavicular joints . "
2837,2991_IM-1378-1001.dcm.png,unknown
2838,2992_IM-1379-2002.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . calcified granuloma within the right lung base . 
2839,2993_IM-1380-1001.dcm.png,"the lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable . "
2840,2994_IM-1380-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
2841,2995_IM-1381-1001.dcm.png,unknown
2842,2996_IM-1381-1001.dcm.png,unknown
2843,2997_IM-1381-2001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues unremarkable . "
2844,2998_IM-1382-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . no displaced rib fractures identified . "
2845,2999_IM-1383-0001-0001.dcm.png,the cardiac silhouette is at the upper limits of normal for size . patchy opacities are demonstrated in the left lung base . no focal pulmonary consolidation . no pneumothorax . minimal degenerative changes of the thoracic spine . 
2846,3000_IM-1386-0001-0001.dcm.png,"there are multiple bilateral pulmonary nodules . for example , there is a 12 mm left lower lobe nodule , seen on the frontal view . there is no pleural effusion or pneumothorax . heart size is within normal limits . the left hilar contour is prominent . there are diffuse degenerative changes of the spine . "
2847,3001_IM-1387-3001.dcm.png,"frontal and lateral views of the chest show an unchanged cardiomediastinal silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and aeration of the lungs . the inferior posterior sulcus is excluded . "
2848,3002_IM-1388-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
2849,3003_IM-1388-1001.dcm.png,"no focal consolidation , pneumothorax , or pleural effusions . stable calcified granulomas . cardiomediastinal silhouette demonstrates mild tortuosity of the thoracic aorta and atherosclerotic calcifications of the aortic xxxx . no acute osseous abnormality identified . "
2850,3004_IM-1388-1001.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . and scattered calcified granulomas . left greater than right basilar opacity , probable atelectasis and/or scarring . no pleural effusion . "
2851,3005_IM-1388-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . aorta is tortuous . calcified lymph are again identified . there is mild prominence of the right paratracheal soft tissues , stable in appearance from prior studies . there is no acute infiltrate or pleural effusion . osteopenia and degenerative changes are identified . deformity of t9 appears worse than prior study . "
2852,3006_IM-1388-1001.dcm.png,cardiomegaly is present . the pulmonary vascularity appears within normal limits . thoracic aorta is tortuous . patient is status post sternotomy . surgical clips are present in the left axilla . lungs are free of focal airspace disease . no pneumothorax or pleural effusion is seen . there is eventration of the right hemidiaphragm . degenerative changes are present in the spine . 
2853,3008_IM-1389-1001.dcm.png,unknown
2854,3009_IM-1389-1001.dcm.png,no focal areas of consolidation . no pleural effusions . no pneumothorax . degenerative changes thoracic spine . heart size normal limits . cholecystectomy clips . 
2855,3010_IM-1389-1001.dcm.png,"heart and mediastinum are at the upper limits of normal size . there is no focal consolidation , pneumothorax , or large pleural effusion . there is no acute , displaced rib fracture . bony structures are unremarkable . "
2856,3011_IM-1390-1001.dcm.png,aortic atherosclerotic calcifications . large hiatal hernia . no pleural effusion or pneumothorax . no focal opacity . cardiomediastinal silhouette is stable in size and appearance . 
2857,3012_IM-1390-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
2858,3013_IM-1391-0001-0001.dcm.png,"the cardiac silhouette is mildly enlarged and appears mildly increased in size from the study . there is normal caliber pulmonary vasculature . the lungs are grossly clear of focal airspace disease , pneumothorax , or pleural effusion . there is no evidence of pulmonary edema . "
2859,3014_IM-1392-1001.dcm.png,there is distortion of the right hilum which may be postsurgical versus neoplastic . volume loss of the right hand side . there is no evidence of focal infiltrate . no pneumothorax . no pleural effusion . normal heart size . 
2860,3015_IM-1392-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
2861,3016_IM-1392-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are clear . thoracic spondylosis . 
2862,3017_IM-1393-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there are opacities in both lung bases compatible with scarring or atelectasis . calcified granuloma in the left upper lung is noted as well as right retrocardiac calcified nodule . no significant pleural effusion is seen . 
2863,3018_IM-1393-1001.dcm.png,heart size within normal limits . no focal airspace disease . stable 4 mm lateral left midlung calcified granuloma . no pneumothorax or pleural effusion . 
2864,3019_IM-1393-1001.dcm.png,the heart is normal in size . the mediastinum is stable with aortic tortuosity . lungs are clear with no pleural effusion or pneumothorax . no displaced rib fractures are noted . there are multilevel degenerative changes of the thoracic spine . 
2865,3020_IM-1395-1001.dcm.png,heart size and mediastinal contours are normal in appearance . no consolidative airspace opacities . no radiographic evidence of pleural effusion or pneumothorax . visualized osseous structures appear intact . 
2866,3021_IM-1396-4004.dcm.png,unknown
2867,3022_IM-1397-1001.dcm.png,unknown
2868,3023_IM-1398-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . small calcified left upper lung granuloma is noted . the lungs are clear . 
2869,3024_IM-1399-1001.dcm.png,"cardiomediastinal silhouette is within normal limits in overall size and appearance . central vascular markings are symmetric and within normal limits . the lungs are normally inflated with no focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
2870,3025_IM-1400-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . no acute displaced rib fractures . "
2871,3026_IM-1401-1001.dcm.png,unknown
2872,3026_IM-1401-3001.dcm.png,unknown
2873,3027_IM-1402-1001.dcm.png,"normal heart size mediastinal contours . no focal airspace consolidation . no pneumothorax or pleural effusion . stable , mild dextro curvature of the spine . "
2874,3028_IM-1403-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . atherosclerotic calcifications of the aortic are again seen . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
2875,3029_IM-1404-1001.dcm.png,normal cardiac contour . clear lung bilaterally . no pleural effusion or pneumothorax . degenerative seen throughout cervical spine . 
2876,3030_IM-1405-3001.dcm.png,normal cardiomediastinal silhouette . there is no focal consolidation . there are no of a large pleural effusion . there is no pneumothorax . there is no acute bony abnormality seen . 
2877,3031_IM-1406-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
2878,3032_IM-1407-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . sternotomy sutures and coronary bypass clips remain intact . 
2879,3033_IM-1408-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2880,3034_IM-1408-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . multilevel cervical arthritis . 
2881,3037_IM-1410-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2882,3038_IM-1411-1001.dcm.png,the heart and mediastinum are unremarkable . there is a calcified granuloma within the left upper lobe . the lungs are clear without infiltrate . there is no effusion or pneumothorax . there are acute mild anterior deformities identified at l1-l2 . there is retropulsion of the posterior vertebral body of l1 . a ct of the lumbar spine was already ordered at the time of this dictation . 
2883,3039_IM-1412-1001.dcm.png,normal heart size . clear lungs . no pneumothorax or large pleural effusion . 
2884,3040_IM-1414-12012.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . minimal degenerative changes of the thoracic spine . there is anterior fusion at the cervicothoracic junction . 
2885,3041_IM-1415-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2886,3043_IM-1417-2001.dcm.png,"the heart and mediastinum are normal . the lungs are clear . there is mild blunting of the right costophrenic xxxx . there is no infiltrate , mass or pneumothorax . the right internal jugular catheter has been removed . "
2887,3044_IM-1418-2001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . external monitor leads the thorax . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
2888,3045_IM-1418-1001.dcm.png,heart size and vascularity normal . mediastinal contour normal . lungs are clear . no pleural effusions or pneumothoraces . 
2889,3046_IM-1418-1001.dcm.png,"redemonstration of azygos lobe . redemonstrated left perihilar nodular opacity , similar in size from previous examination . dense appearing , may be granulomatous . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . xxxx . limited exam , for evaluation of fractures . however , no evidence for displaced rib fracture . "
2890,3047_IM-1418-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
2891,3049_IM-1420-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2892,3050_IM-1420-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
2893,3051_IM-1420-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
2894,3052_IM-1420-1001.dcm.png,"normal heart size . density surrounding superior mediastinum reflex combination of vascular , osseous common pleural structures . no focal airspace consolidation . moderate degenerative disc disease with osteophyte formation bridging . "
2895,3053_IM-1421-1001.dcm.png,unknown
2896,3054_IM-1422-2002.dcm.png,the patient is status post cabg . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . ureteral stents are noted on the right . 
2897,3058_IM-1425-12012.dcm.png,"left midlung opacity noted , not visualized on prior . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures intact . "
2898,3058_IM-1425-2002.dcm.png,"left midlung opacity noted , not visualized on prior . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures intact . "
2899,3059_IM-1425-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . are unremarkable . "
2900,3060_IM-1426-1003.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are grossly clear . 
2901,3061_IM-1427-2001.dcm.png,the heart size and pulmonary vascularity appear within normal units . no pleural effusion or pneumothorax is seen . bandlike opacities are present in the right base consistent with areas of atelectasis . remainder of the lungs appear clear . 
2902,3062_IM-1428-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . minimal blunting of the left costophrenic xxxx . no pneumothorax . visualized bony structures are unremarkable in appearance . 
2903,3063_IM-1428-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2904,3064_IM-1428-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is patchy airspace disease in the right lower lobe . the lungs are otherwise grossly clear . there is no pneumothorax or pleural effusion . 
2905,3065_IM-1429-1001.dcm.png,lungs are without focal airspace disease . no pleural effusions or pneumothoraces . heart size is normal status post sternotomy . degenerative changes in the thoracic spine . incidental note is of previous left rotator repair . 
2906,3066_IM-1430-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild emphysematous changes without focal consolidation . there is no pleural effusion . lingular scarring or atelectasis noted . 
2907,3067_IM-1430-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
2908,3069_IM-1432-1001.dcm.png,right upper lobe airspace disease consistent with pneumonia given patient's history . the lungs are otherwise clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
2909,3070_IM-1432-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
2910,3071_IM-1433-1001.dcm.png,heart size is normal . the lungs are clear . there are no focal air space consolidations . no pleural effusions or pneumothoraces . the hilar and mediastinal contours are normal . normal pulmonary vascularity . 
2911,3072_IM-1433-1001.dcm.png,"left-sided medication injection has its tip projecting at the cavoatrial junction . the trachea is midline . extensive bilateral bronchiectasis , cystic changes , and scarring represents sequela from the patient's cystic fibrosis . no evidence of focal pulmonary infiltrate or pleural effusion . no large pneumothorax has developed in the interim . the overlying bony structures reveal no acute abnormalities . the heart size is normal . "
2912,3073_IM-1434-1001.dcm.png,"heart size and cardiomediastinal contours are normal . lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . no displaced rib fracture . "
2913,3074_IM-1435-1001.dcm.png,sequelae of old granulomatous disease . vague patchy opacity in the right midlung which may represent early pneumonia . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
2914,3075_IM-1436-1001.dcm.png,"the heart is mildly enlarged . lung volumes are low . there is no focal consolidation , pneumothorax , or large pleural effusion . bony structures are within normal limits . there is no free air under the diaphragm . there is a mild amount of seen in the transverse colon . "
2915,3076_IM-1437-4004.dcm.png,"frontal view kyphotic and rotated , low lung volumes with bronchovascular crowding . otherwise , no definite airspace consolidation or pleural effusion . accounting for technical factors heart size borderline enlarged . "
2916,3077_IM-1438-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . low left paraspinal/retrocrural adenopathy is present . this appears unchanged . 
2917,3078_IM-1438-1001.dcm.png,the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . there is a right lower lobe pneumonia . no pleural effusion . no pneumothorax . 
2918,3079_IM-1438-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . multilevel degenerative changes are seen throughout the thoracic spine . anchors over the left humeral head . there is mild bilateral acromioclavicular joint osteoarthritis . visualized upper abdomen is grossly unremarkable in appearance . "
2919,3080_IM-1440-1001.dcm.png,the cavity and the left upper lobe has decreased in size . bilateral apical bullae and parenchymal scars are unchanged . no infiltrates in the lower lobes . heart size remains normal . 
2920,3081_IM-1440-1001.dcm.png,"the heart is normal in size . the aorta is tortuous and ectatic . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
2921,3082_IM-1441-1001.dcm.png,cardiomegaly . interstitial opacities consistent with edema in the lower lobes . no pneumothorax . no large pleural effusion . 
2922,3083_IM-1442-7001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . . 
2923,3084_IM-1443-1001.dcm.png,heart size is normal . no pleural effusions . no pneumothorax . no focal air space opacities . mild degenerative osteophytes are noted in the thoracic spine . 
2924,3085_IM-1444-1001.dcm.png,"normal cardiomediastinal contours . marrow pneumothorax , focal lung consolidation or pleural effusions . "
2925,3086_IM-1444-1001.dcm.png,"no airspace disease , effusion or noncalcified nodule . calcified granuloma seen bilaterally . normal heart size . elevated right hemidiaphragm , with a nodular soft tissue contour , containing liver . degenerative changes demonstrated within the visualized thoracic spine . there is neurostimulator , overlying the mid and lower thoracic spine . "
2926,3087_IM-1444-1001.dcm.png,the heart is enlarged . the mediastinal contours are stable . large hiatal hernia is identified containing stomach and colon . questionable small bowel loops are also visualized inthe large hernia . there is adjacent compressive atelectasis . the lungs are clear . 
2927,3088_IM-1444-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . no focal pulmonary opacity , pleural effusion or pneumothorax . there is levoscoliosis of the thoracic spine . "
2928,3089_IM-1444-1001.dcm.png,normal heart size and mediastinal contours . no abnormal airspace opacities . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . 
2929,3090_IM-1445-1001.dcm.png,normal cardiac contour . right sided pleural effusion . clear left lung xxxx . no pneumothorax . 
2930,3091_IM-1445-1001.dcm.png,the heart size is mildly enlarged . the patient is post aortic valve replacement . the sternotomy are intact . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there mild degenerative changes of the spine . 
2931,3092_IM-1445-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . levoscoliosis of the thoracolumbar spine is present . 
2932,3093_IM-1446-1001.dcm.png,lungs are hyperexpanded . bullae are present in the upper lobes . no focal infiltrates . heart size normal . 
2933,3094_IM-1447-2001.dcm.png,heart size is normal . lungs are clear . low lung volumes . there is no pneumothorax or large pleural effusion . 
2934,3095_IM-1448-1001.dcm.png,"heart size is mildly enlarged . there are diffusely increased interstitial opacities bilaterally . no focal consolidation , pneumothorax , or pleural effusion . no acute bony abnormality . "
2935,3096_IM-1448-1001.dcm.png,the heart is normal in size . prominent right paratracheal soft tissue density . rounded mass in the right middle lobe measures approximately 4 . 6 cm x 3 . 7 cm . there is mild surrounding airspace disease and/or atelectasis . no pleural effusions noted . the visualized bony thorax appears grossly intact . 
2936,3097_IM-1449-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . vascular calcification is identified . calcified granuloma is present in the right lower lobe . no nodules are seen . no pneumothorax or pleural effusion is seen . no focal airspace disease is identified . 
2937,3098_IM-1450-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
2938,3099_IM-1450-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues grossly unremarkable . calcified left hilar xxxx . "
2939,3100_IM-1452-1001.dcm.png,lungs are hyperexpanded but clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
2940,3101_IM-1453-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . stent is noted in the abdomen . the thoracic aorta is tortuous . calcified granuloma are noted . 
2941,3102_IM-1454-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2942,3103_IM-1454-1001.dcm.png,"cardiomediastinal silhouette stable and unremarkable . stable eventration of the right hemidiaphragm . there is redemonstration without significant interval change of mild subsegmental atelectasis of the left base . pneumonia seen on ct examination dated xxxx , ( not seen on prior chest x-xxxx ) is not seen either on chest x-xxxx . "
2943,3104_IM-1455-1001.dcm.png,unknown
2944,3105_IM-1456-1001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
2945,3106_IM-1456-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
2946,3108_IM-1457-1001.dcm.png,there is airspace disease in the right lower lobe seen behind the right hemidiaphragm on pa view . this is also well seen on lateral view . remainder of the lungs appear clear . the heart and pulmonary appear normal . mediastinal contours are normal . 
2947,3108_IM-1457-12001.dcm.png,there is airspace disease in the right lower lobe seen behind the right hemidiaphragm on pa view . this is also well seen on lateral view . remainder of the lungs appear clear . the heart and pulmonary appear normal . mediastinal contours are normal . 
2948,3109_IM-1458-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no pneumothorax . 
2949,3110_IM-1460-1001.dcm.png,"heart size , mediastinal and aortic contours are within normal limits . normal pulmonary vasculature . the lungs are clear . no visible pneumothorax or large pleural effusion . elevated right hemidiaphragm . mild degenerative changes of the spine . "
2950,3111_IM-1461-1001.dcm.png,stable appearance of previous sternotomy . stable cardiomegaly . stable mild bilateral interstitial opacities in which may represent mild pulmonary edema . no evidence of large pleural effusion or pneumothorax . 
2951,3112_IM-1461-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2952,3113_IM-1462-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . there is no evidence for mass lung apices . the heart is normal . there are atherosclerotic changes of the aorta . the skeletal structures are unremarkable . 
2953,3114_IM-1462-1001.dcm.png,unknown
2954,3115_IM-1463-1001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
2955,3116_IM-1464-1001.dcm.png,the cardiac silhouette is enlarged . there are bibasilar airspace opacities left greater than right with small right pleural effusion . no visualized pneumothorax . 
2956,3117_IM-1465-1001.dcm.png,heart size is normal . the lungs and costophrenic are clear . the bony thorax is grossly intact . 
2957,3118_IM-1466-1001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . heart size normal . cardiomediastinal silhouette stable . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . "
2958,3119_IM-1466-1001.dcm.png,heart size is normal . no focal airspace consolidations . no pneumothorax or pleural effusion . no acute osseous findings . 
2959,3120_IM-1466-1001.dcm.png,"the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . fractures of the posterior left 4th , 5th , and 6th ribs , age-indeterminate . "
2960,3121_IM-1466-1001.dcm.png,"heart size and mediastinal contour within normal limits . calcified granuloma right midlung . no focal airspace consolidation , pneumothorax , or large pleural effusion . degenerative changes in the thoracic spine . "
2961,3122_IM-1467-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
2962,3123_IM-1468-1001.dcm.png,the heart is enlarged . changes of sternotomy and bypass graft are identified in the lungs are grossly clear . right pleural thickening versus pleural effusion is noted . there is no acute infiltrate . no pneumothorax is seen . mild granulomatous sequela are noted . 
2963,3124_IM-1468-1001.dcm.png,"there is persistent , marked enlargement of the pulmonary arteries . normal heart size . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . "
2964,3125_IM-1469-1001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax or large pleural effusion . "
2965,3126_IM-1470-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute , displaced rib fractures . "
2966,3127_IM-1470-1001.dcm.png,the heart size is normal . there is prominent left epicardial fat . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
2967,3128_IM-1471-1001.dcm.png,"calcified left hilar lymph from prior granulomatous disease . the cardiomediastinal silhouette is within normal limits for size . pulmonary vasculature is within normal limits . no focal consolidations , effusions , or pneumothoraces . no acute bony abnormality . "
2968,3129_IM-1471-3001.dcm.png,heart size within normal limits . tortuous aorta . there is an accessory azygos fissure in the right upper lung . no focal air space consolidations are noted . no pneumothorax or pleural effusion . there is severe degenerative change at the thoracolumbar junction with mild anterior wedging at approximately t12 . 
2969,3130_IM-1472-1001.dcm.png,"2 images . heart size is enlarged , stable . thoracic aortic atherosclerotic calcifications are present . there is dense consolidation within the retrocardiac left lower lobe . there is also patchy airspace opacity within the perihilar right lung . no pleural effusion or pneumothorax . "
2970,3131_IM-1473-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . the heart size and cardiomediastinal silhouette are grossly unremarkable . 
2971,3132_IM-1473-1001.dcm.png,the and soft tissue appear normal . the cardiac silhouette and mediastinum size are normal . the aortic is on the left . the trachea is well seen and appears normal . the lungs are clear . 
2972,3133_IM-1474-1001.dcm.png,unknown
2973,3134_IM-1474-1001.dcm.png,lungs appear clear . heart and pulmonary appear normal . pleural spaces are clear . mediastinal contours are normal . no pneumothorax . 
2974,3135_IM-1474-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2975,3136_IM-1475-1001.dcm.png,"cardiac size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , pleural effusion , or pneumothorax . the visualized osseous structures appear intact . "
2976,3137_IM-1476-1001.dcm.png,"the trachea is midline . cardiomediastinal silhouette is normal . there is a calcified density in the left mid lung , most a calcified granuloma . lungs are otherwise clear , without evidence of acute infiltrate or effusion . specifically , there is no evidence of tuberculous disease . there is no pneumothorax . the bony structures show no acute abnormalities . "
2977,3138_IM-1476-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear , without evidence of acute infiltrate or effusion . there is no evidence of tuberculous disease . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
2978,3139_IM-1476-1001.dcm.png,no focal areas of consolidation . no pleural effusions . no evidence of pneumothorax . heart size within normal limits . osseous structures intact . 
2979,3140_IM-1477-1001.dcm.png,unknown
2980,3141_IM-1477-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pleural effusion is identified . 
2981,3142_IM-1477-2001.dcm.png,"there is stable mild cardiomegaly without significant pulmonary vascular congestion . they're stable tortuosity of the aorta . there is no acute pulmonary consolidation , large effusion or pneumothorax . "
2982,3143_IM-1477-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
2983,3144_IM-1478-1001.dcm.png,and lateral views of the chest were obtained on xxxx . the lung volumes are normal . the lungs are clear and there are no pleural effusions . the mediastinum and pulmonary are normal . the bony elements are not remarkable . 
2984,3145_IM-1479-1001.dcm.png,unknown
2985,3146_IM-1479-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
2986,3147_IM-1480-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
2987,3148_IM-1480-1001.dcm.png,stable cardiomediastinal contour is mild cardiomegaly . no pneumothorax or significant pulmonary edema . small left pleural effusion . no focal lung consolidation . mildly low lung volumes . 
2988,3149_IM-1480-1001.dcm.png,"the lungs are hyperexpanded . cardiomediastinal silhouette is within normal limits . no pleural effusion , focal airspace opacities or pneumothorax . no free subdiaphragmatic air . "
2989,3150_IM-1482-3001.dcm.png,"the trachea is midline . cardiomediastinal silhouette is normal . the there are opacities in the left lower lobe of the lung , which are most dependent atelectasis . there is no pneumothorax . visualized bony structures reveal no acute abnormalities . "
2990,3152_IM-1484-1001.dcm.png,"the lungs are hyperexpanded . there are stable scattered bilateral opacities , most notable in the left upper lobe , scarring . no focal airspace consolidation to suggest pneumonia . no large pleural effusion . no pneumothorax . heart size is normal . thoracic aorta is mildly tortuous and demonstrates atherosclerotic vascular calcification . there are degenerative changes of the spine . "
2991,3153_IM-1485-1001.dcm.png,unknown
2992,3155_IM-1486-1001.dcm.png,"heart size mildly enlarged with enlarged right atrium . no focal alveolar consolidation , no definite pleural effusion seen . no pneumothorax . "
2993,3156_IM-1486-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
2994,3157_IM-1487-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
2995,3158_IM-1487-1001.dcm.png,cardiomegaly is present . the pulmonary vascularity appears within normal limits . some scattered opacities are present whose appearance scarring or atelectasis . no focal airspace disease is seen . no pleural effusion is noted . no pneumothorax is identified . the left hemidiaphragm is elevated . scoliosis is present involving the lumbar spine . there has been previous surgical resection of the left 6th rib . 
2996,3159_IM-1487-1001-0001.dcm.png,moderate cardiomegaly . prominent vascular pedicle/upper mediastinal contour . mild central vascular congestion . no overt edema or confluent lobar pneumonia . no pleural effusion . thoracic spondylosis . 
2997,3162_IM-1487-1001.dcm.png,unknown
2998,3163_IM-1488-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
2999,3164_IM-1489-0001-0002.dcm.png,unknown
3000,3165_IM-1490-13013.dcm.png,"normal and stable cardiomediastinal contours . interval removal of left-sided intravenous catheter . no pneumothorax . opacities obscuring the hemidiaphragms , slightly improved from prior exam . . right-sided rib fractures again noted . "
3001,3166_IM-1491-2001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . "
3002,3167_IM-1491-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
3003,3168_IM-1492-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . chronic appearing left lateral rib deformities . 
3004,3169_IM-1492-2001.dcm.png,hyperlucent hyperinflated lungs with flattened diaphragms . granulomas . small sized heart . minimal apical capping slightly greater at the left . unremarkable . 
3005,3170_IM-1494-1001.dcm.png,heart size is normal . aorta is tortuous and ectatic . cardiomediastinal contours are normal . lungs are clear without evidence of fibrosis . pleural effusions or pneumothorax . endplate sclerotic changes are present in the thoracic spine . 
3006,3171_IM-1494-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3007,3172_IM-1494-1001.dcm.png,trachea is midline . the cardiomediastinal silhouette is normal . the lungs are clear without evidence of acute infiltrate or effusion . there is no evidence of tuberculous disease . there is no pneumothorax . there is dextroscoliosis of the lower thoracic spine . 
3008,3173_IM-1495-2002.dcm.png,lungs are clear . heart size normal . no pneumothorax . 
3009,3174_IM-1496-4004.dcm.png,"the lungs are hyperinflated with biapical pleural-parenchymal scarring and upward retraction of the xxxx , similar to the prior study . there are multiple reticular-nodular opacities in the upper lobes bilaterally which appear grossly stable from the prior study . there is no evidence of xxxx , focal airspace disease . there is no pneumothorax or pleural effusion . heart size is normal . "
3010,3175_IM-1497-1001.dcm.png,"stable obscuration of the left cardiac xxxx , representing left pleural thickening . stable nodular opacity within the left midlung . the lungs are clear bilaterally with no focal consolidation , pleural effusions , or pneumothoraces . cardiomediastinal silhouette is stable . are unremarkable . "
3011,3176_IM-1497-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3012,3177_IM-1497-1001.dcm.png,the lungs are clear . there is hyperinflation of the lungs . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . mild arthritic changes of the spine are present . 
3013,3178_IM-1498-1001.dcm.png,unknown
3014,3179_IM-1499-1001.dcm.png,"the cardiac silhouette measures near upper limits of normal in size . pulmonary vasculature is normal in caliber . there is stable eventration of the anterior right hemidiaphragm . the lungs are clear of focal airspace disease , pneumothorax , pleural effusion . there are no acute bony findings . "
3015,3180_IM-1500-3001.dcm.png,"the heart is normal in size and contour . the lungs are clear , without evidence of infiltrate . there is no pneumothorax or effusion . "
3016,3181_IM-1500-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3017,3182_IM-1501-0001-0001.dcm.png,there is a moderate amount of retained contrast within the distal esophagus . there is no evidence of aspiration . a 3 . 0 cm nodule is present within the right hilum . no moderate to large pleural effusion or pneumothorax is identified . the cardiomediastinal silhouette is within normal limits . the pulmonary vasculature is normal . 
3018,3183_IM-1502-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3019,3184_IM-1503-1001.dcm.png,the aortic is mildly tortuous . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . there are t-spine osteophytes . large body habitus . 
3020,3185_IM-1503-1001.dcm.png,the cardiomediastinal silhouette is normal in size and appearance . the lung are clear . there are no soft tissue or bony abnormalities . there is no pneumothorax or pleural effusion . 
3021,3186_IM-1503-1001.dcm.png,the lungs are hypoventilated . there is no focal consolidation . cardiomediastinal silhouette is normal in size and contour . there is no pneumothorax or large pleural effusion . 
3022,3187_IM-1503-1001.dcm.png,"pa and lateral views . stable postoperative changes with midline sternotomy and myocardial revascularization . cardiac size remains mildly enlarged but stable . there is mild vascular congestion . small bilateral pleural effusions are present , which are xxxx . "
3023,3188_IM-1504-1001.dcm.png,unknown
3024,3189_IM-1505-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hypoinflated but grossly clear . 
3025,3190_IM-1505-1001.dcm.png,the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . there is a vague right suprahilar density with elevation of the fissure most mild subsegmental atelectasis though superimposed infection cannot be entirely excluded . the remaining lungs are clear . the visualized osseous structures and upper abdomen are unremarkable . 
3026,3191_IM-1505-1001.dcm.png,borderline cardiac enlargement . enlarged calcified thoracic aorta . emphysema . no acute pulmonary abnormality . mild spondylosis . 
3027,3192_IM-1505-1001.dcm.png,"the heart is normal in size . mild fullness of the left hilum , small interval change from prior exam . lucencies throughout the chest representing emphysematous change . scattered bilateral calcified granulomas . no pneumothorax . large hiatal hernia , increased from prior exam . "
3028,3193_IM-1505-1001.dcm.png,"mild hyperinflation . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . heart size and pulmonary vascularity within normal limits , visualized osseous structures appear intact . "
3029,3194_IM-1505-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
3030,3195_IM-1506-0001-0002.dcm.png,there is a left base opacity . the right lung is grossly clear . heart size is normal . left venous catheter with tip in the right atrium . there is no pneumothorax . 
3031,3196_IM-1507-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3032,3197_IM-1508-1001.dcm.png,unknown
3033,3198_IM-1509-4004.dcm.png,unknown
3034,3199_IM-1510-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3035,3200_IM-1512-1001.dcm.png,unknown
3036,3201_IM-1513-1001.dcm.png,lung volumes are low . no focal infiltrates . heart size normal . mediastinum normal . 
3037,3202_IM-1513-1001.dcm.png,normal heart size and mediastinal contours . no focal airspace opacity . no pleural effusion or pneumothorax . multiple healed posterior left rib fractures . 
3038,3203_IM-1513-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3039,3204_IM-1513-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart is normal . there are atherosclerotic changes of the aorta . senescent changes of the spine are seen . 
3040,3205_IM-1513-1001.dcm.png,no pneumothorax . heart size is normal . no large pleural effusions . no focal airspace opacities . no definite visualized rib fractures . 
3041,3206_IM-1513-1001.dcm.png,heart size is normal . no large effusions . no focal airspace opacities . no pneumothorax . 
3042,3207_IM-1514-1001.dcm.png,there's been interval enlargement in the cardiac silhouette . these xxxx't contours are within normal limits . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
3043,3208_IM-1515-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . normal heart size and mediastinal contour . 
3044,3209_IM-1515-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
3045,3210_IM-1517-1001.dcm.png,"2 images . heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
3046,3211_IM-1517-1001-0002.dcm.png,the lungs are clear . there appear to be small bilateral pleural effusions . the heart is not grossly enlarged . there are atherosclerotic changes of the aorta . increased kyphosis is seen in the may be a thoracic deformity that is not well-characterized . arthritic changes are seen . 
3047,3212_IM-1517-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax grossly unremarkable . "
3048,3213_IM-1518-3001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is a calcified granuloma within the right middle lobe . "
3049,3214_IM-1519-1001.dcm.png,"there is an marked interval increase in heart size . the heart also demonstrates the configuration , compatible with pericardial effusion . a small right pleural effusion the present . the lungs are otherwise clear without focal infiltrates . normal pulmonary vascularity . no pneumothorax . "
3050,3215_IM-1520-1002.dcm.png,unknown
3051,3216_IM-1520-1001.dcm.png,"heart size is normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures are intact . "
3052,3218_IM-1520-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . there is degenerative changes of the skeletal structures
3053,3218_IM-1520-3001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . there is degenerative changes of the skeletal structures
3054,3219_IM-1520-1001.dcm.png,unknown
3055,3220_IM-1522-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
3056,3221_IM-1522-1002.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3057,3222_IM-1522-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3058,3223_IM-1523-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3059,3224_IM-1524-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
3060,3225_IM-1525-1001.dcm.png,unknown
3061,3226_IM-1525-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
3062,3227_IM-1525-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute osseus abnormality . "
3063,3228_IM-1526-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . there is again biapical scarring . small stable calcified left lower lobe granuloma . the lungs are otherwise clear . 
3064,3229_IM-1526-1001.dcm.png,heart size within normal limits . trachea is midline . the lung volumes are is somewhat low . both lungs are otherwise clear bilaterally . no pleural effusion . no pulmonary nodules visualized . 
3065,3230_IM-1527-2001.dcm.png,"low lung volumes and patient rotation . given differences in technique , heart size within normal limits . persistent right basilar opacity , atelectasis . no suspicious pulmonary opacity , pneumothorax or definite pleural effusion . mild degenerative change of the thoracic spine . "
3066,3231_IM-1528-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size within normal limits . there is tortuosity of the descending thoracic aorta , unchanged . there is right paratracheal thickening and bilateral hilar enlargement corresponding to lymphadenopathy and pulmonary arterial enlargement visualized on chest in xxxx . radiographically , the findings are grossly stable . "
3067,3232_IM-1529-1001.dcm.png,"heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . in the left midlung zone , there has been development of a small lung nodule . this measures approximately 8 mm in diameter . "
3068,3233_IM-1530-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are mildly hyperinflated with flattening of the hemidiaphragms . coarsened interstitial testes appear chronic and compatible with emphysema . there is minimal scarring or atelectasis in the left lung base . the lungs are otherwise clear of focal infiltrate , pneumothorax , or pleural effusion . there are no acute bony findings . "
3069,3234_IM-1531-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3070,3235_IM-1532-1001.dcm.png,heart size is normal . the lungs are clear . no pneumothorax or pleural effusion . 
3071,3236_IM-1533-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
3072,3238_IM-1534-1001.dcm.png,the heart is normal in size . the mediastinal contours are within normal limits . aorta is mildly tortuous and demonstrates atherosclerotic calcifications . the lungs are mildly hypoinflated with increased peripheral lung markings noted predominantly in the right upper and lower lung . there is no acute infiltrate or significant pleural effusion . mild eventration of left hemidiaphragm is noted . 
3073,3239_IM-1534-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3074,3240_IM-1534-1001.dcm.png,the cardiac contours are normal . the lungs are hyperinflated with flattening of the diaphragms and tapering of the distal pulmonary vasculature . there is no focal consolidation . thoracic spondylosis . 
3075,3241_IM-1534-1001.dcm.png,the lungs focal airspace consolidation . there is atelectasis of the left lung base . the cardiomediastinal silhouette is normal in size and contour . there is no pneumothorax or large pleural effusion . cervical vertebral is partially visible at the top of the radiographs . 
3076,3242_IM-1534-1001.dcm.png,"the heart and cardiomediastinal silhouette are normal in size and contour . there is no focal air space opacity , pleural effusion , or pneumothorax . there are multilevel degenerative changes in the thoracic spine . "
3077,3243_IM-1535-0001-0001.dcm.png,normal heart size . diffuse bilateral reticulonodular interstitial opacities . there are no of a large pleural effusion . there is no evidence of pneumothorax . heart is not enlarged . are unremarkable . 
3078,3244_IM-1536-1001.dcm.png,heart size within normal limits . right paratracheal prominence represents tortuous xxxx . lung volumes . mild streaky bibasilar opacities . no pleural effusion or pneumothorax . 
3079,3245_IM-1537-1001.dcm.png,"moderate bilateral interstitial edema , with cardiomegaly and bilateral effusion consistent with moderate cardiac failure . a large calcified right mediastinal adenopathy , chronic fungal . no pneumothorax . "
3080,3245_IM-1537-4001.dcm.png,"moderate bilateral interstitial edema , with cardiomegaly and bilateral effusion consistent with moderate cardiac failure . a large calcified right mediastinal adenopathy , chronic fungal . no pneumothorax . "
3081,3246_IM-1538-1001.dcm.png,the cardiac contours are normal . prominent pulmonary arteries . the lungs are clear . thoracic spondylosis . 
3082,3247_IM-1538-1001.dcm.png,unknown
3083,3248_IM-1538-1001.dcm.png,unknown
3084,3249_IM-1539-1001.dcm.png,the examination consists of frontal and lateral radiographs of the chest . again seen is evidence of prior cabg . the cardiomediastinal contours are unchanged . right and left pleural effusions . there is right greater than left bibasilar atelectasis . b-lines seen at the lung bases . no consolidation or pneumothorax . 
3085,3250_IM-1540-1001-0002.dcm.png,lungs are relatively clear . heart size normal . unfolded aorta . moderate hiatal hernia . t-spine osteophytes and dish . 
3086,3251_IM-1541-1001.dcm.png,"right mid lung nodule stable xxxx; etiology not determined . this is noncalcified , and is stable since a ct examination from and is benign etiology . the lungs are well inflated and without focal consolidation . the cardiomediastinal silhouette appears unremarkable . costophrenic clear . visualized spine vertebrae appear normal in and alignment . overlying leads . "
3087,3252_IM-1542-1001.dcm.png,no evidence of airspace opacity . no effusion or noncalcified nodules . no evidence of pneumothorax . normal heart size and mediastinum . visualized of the chest are within normal limits . 
3088,3253_IM-1542-1001.dcm.png,"pa and lateral views the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . the lungs are well aerated . no pneumothorax , pleural effusion , or focal air space consolidation . "
3089,3254_IM-1543-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
3090,3256_IM-1543-1001.dcm.png,"there is mild cardiomegaly . mediastinal contours appear within normal limits . there are small bilateral pleural effusions , left greater than right with left basilar opacities . no pneumothorax . mild degenerative changes of the thoracic spine . "
3091,3257_IM-1544-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
3092,3258_IM-1544-1001.dcm.png,normal heart size and mediastinal contours . the lungs are clear . there is no pneumothorax or pleural effusion . the are unremarkable . 
3093,3259_IM-1545-1001.dcm.png,there is a large calcified granuloma in the right apex . mild patchy opacities are seen in the upper lung zones bilaterally similar to prior studies . the heart and mediastinum are normal . scoliosis and arthritic changes of the spine are present . 
3094,3260_IM-1547-1001.dcm.png,1 . cardiomegaly and/or pericardial effusion . 2 . right base opacity combination of pleural effusion and atelectasis/airspace disease . cannot exclude elevation right hemidiaphragm . 3 . left lung relatively clear . 4 . limited exam due to underpenetrated technique related to large patient habitus . 5 . no evidence of pneumothorax . 
3095,3261_IM-1547-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3096,3262_IM-1548-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . lungs are clear without focal consolidation . no pneumothorax or large pleural effusion . 
3097,3262_IM-1548-3001.dcm.png,the cardiomediastinal silhouette is within normal limits . lungs are clear without focal consolidation . no pneumothorax or large pleural effusion . 
3098,3263_IM-1549-1001.dcm.png,"chest: the heart size and cardiomediastinal silhouette are normal . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . left knee: there is no fracture-dislocation . there are degenerative changes with medial compartment osteophytes . there is no suprapatellar effusion . there is a xxxx . "
3099,3263_IM-1549-3001.dcm.png,"chest: the heart size and cardiomediastinal silhouette are normal . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . left knee: there is no fracture-dislocation . there are degenerative changes with medial compartment osteophytes . there is no suprapatellar effusion . there is a xxxx . "
3100,3264_IM-1550-1001.dcm.png,"calcified granulomas noted . symmetric apical scarring . the diaphragms are flattened , and the chest is somewhat shaped . the cardiothymic silhouette is within normal limits for size . pulmonary vascularity is unremarkable . no acute bony abnormality . "
3101,3265_IM-1551-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
3102,3266_IM-1551-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
3103,3267_IM-1551-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours , lungs , pleura , osseous structures and visualized upper abdomen are normal . "
3104,3268_IM-1551-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3105,3269_IM-1552-1001.dcm.png,heart size within normal limits . cardiomediastinal silhouette is normal in contour . lungs are clear bilaterally . no focal consolidations . no pleural effusions . bony structures are intact . 
3106,3270_IM-1552-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . there are endplate changes within the spine . 
3107,3271_IM-1552-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3108,3272_IM-1553-1001.dcm.png,lung volumes remain xxxx . opacities are present in both lower lobes . old rib fractures and pleural thickening are present on the right . heart and pulmonary are normal . 
3109,3273_IM-1554-1001.dcm.png,"cardiomegaly . no focal consolidation , effusion , or pneumothorax . mild unfolding of the thoracic aorta . bony thorax and soft tissues grossly unremarkable . "
3110,3274_IM-1555-0001-0001.dcm.png,unknown
3111,3275_IM-1556-1002001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . mild degenerative changes of the spine . 
3112,3275_IM-1556-1003002.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . mild degenerative changes of the spine . 
3113,3277_IM-1558-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are without focal consolidation , pneumothorax , or pleural effusion . calcified left hilar lymph xxxx . a calcified granuloma is seen in the left lower lobe . bony thorax is unremarkable . "
3114,3278_IM-1559-0001.dcm.png,"chest: 2 images . heart size is normal . mediastinal contours are maintained . there is a mild pectus excavatum deformity . the lungs are clear of focal infiltrate . there is no evidence for pleural effusion or pneumothorax . no convincing acute bony findings . right shoulder: 3 images . there has been and screw fixation of the midshaft right clavicle . the lateral most screw is fractured . this is age-indeterminate as no prior studies are available for comparison . otherwise , the surgical appears intact . the humeral head is seen within the glenoid , without evidence for dislocation . no bony fractures are seen . the visualized right ribs appear intact . right clavicle: 2 images . no clavicle fracture is seen . once again noted is the surgical fixation xxxx , with fracture of the lateral most fixation screw . "
3115,3279_IM-1560-1001.dcm.png,the heart size is normal and cardiomediastinal silhouette is normal in contour . lungs are clear bilaterally . there is no pleural effusion or pneumothorax . no bony or soft tissue abnormalities . 
3116,3280_IM-1561-2001.dcm.png,right middle lobe opacity is present . the cardiac silhouette and mediastinal contours are within normal limits . there is no pneumothorax . no large pleural effusion . 
3117,3281_IM-1562-1001.dcm.png,the heart size is within normal limits . cardiomediastinal contour is normal . there is a right upper lobe nodule measuring 8 mm in diameter . trachea is midline . the lungs otherwise clear . and soft tissues are unremarkable . 
3118,3281_IM-1562-3001.dcm.png,the heart size is within normal limits . cardiomediastinal contour is normal . there is a right upper lobe nodule measuring 8 mm in diameter . trachea is midline . the lungs otherwise clear . and soft tissues are unremarkable . 
3119,3282_IM-1563-2001.dcm.png,"low lung volumes bilaterally , with lungs otherwise grossly clear . no focal consolidation , pneumothorax , or large pleural effusion . the cardiomediastinal silhouette is unremarkable . no acute osseous abnormalities identified . "
3120,3283_IM-1564-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
3121,3284_IM-1565-20001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
3122,3285_IM-1566-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3123,3286_IM-1567-1001.dcm.png,"lung volumes are low . the heart is large , the pulmonary are engorged . no infiltrates . opacity is present in the left midlung . "
3124,3287_IM-1568-2002.dcm.png,"heart size and mediastinal contour normal . there is a 2 . 5 cm vague nodular density in the right mid lung , probably within the middle lobe given the opacification on the lateral view . there is a subtle left retrocardiac density also noted , with obscuration of aortic contour . no pleural effusions or pneumothorax . "
3125,3288_IM-1569-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3126,3289_IM-1570-1001.dcm.png,"normal cardiac size and contour , unremarkable mediastinal silhouette . normal pulmonary xxxx . lungs clear , no airspace disease , pleural effusion , or pneumothorax . "
3127,3290_IM-1572-1001.dcm.png,unknown
3128,3291_IM-1572-1001.dcm.png,the lungs are clear . the heart and pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
3129,3292_IM-1572-1001.dcm.png,mediastinal contours are normal . opacity within the right middle and lower lobes . no displacement of the or fissure . no pneumothorax . . 
3130,3294_IM-1573-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is tortuous . a calcified granuloma is identified in the right middle lobe . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute displaced rib fractures . 
3131,3296_IM-1575-1001-0001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . calcified left hilar node . 
3132,3297_IM-1575-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . mild emphysematous changes are noted . the lungs are otherwise clear . 
3133,3298_IM-1575-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . 
3134,3299_IM-1575-1001.dcm.png,the cardiac silhouette and mediastinal contours are within normal limits . there are low lung volumes with bronchovascular crowding . otherwise the lungs are clear . there is no pneumothorax . no large pleural effusion . 
3135,3300_IM-1578-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . stable aortic tortuosity . cardiomediastinal silhouette is otherwise unremarkable . scoliosis and degenerative changes of the thoracic spine . stent visualized in the right upper quadrant , biliary stent . "
3136,3301_IM-1579-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3137,3302_IM-1579-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are slightly hypoinflated but clear . there is no pleural effusion . 
3138,3303_IM-1580-3001.dcm.png,"heart size and mediastinal contours appear within normal limits . there is a vague 1 . 6 cm nodular opacity in the right upper lobe between the anterior second and third ribs , which could represent focal infiltrate or lung nodule . no pleural effusion . no pneumothorax . no acute bony abnormality . "
3139,3304_IM-1581-1001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . there is levoscoliosis of the thoracic spine . "
3140,3305_IM-1581-4001.dcm.png,there is a right picc with tip overlying the right brachiocephalic vein . the cardiac silhouette is enlarged . no overt pulmonary edema . there are streaky bibasilar opacities . no large pleural effusion . the right hemidiaphragm is elevated . no pneumothorax is identified . there are degenerative changes of the spine . bilateral surgical clips are noted . 
3141,3307_IM-1582-1002001.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
3142,3307_IM-1582-1003002.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
3143,3307_IM-1582-1004003.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . "
3144,3309_IM-1583-1001.dcm.png,heart and mediastinum are within normal limits . no focal consolidation . no large pleural effusion or pneumothorax . no acute bony abnormality . 
3145,3310_IM-1585-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . cardiomediastinal size is within normal limits . pulmonary vasculature is normal . intact . chondral cartilages causing over the anterior lungs on lateral view . "
3146,3311_IM-1586-1001.dcm.png,the lungs are clear . there is no pleural effusion . the heart and mediastinum are normal as are the skeletal structures and soft tissues . 
3147,3312_IM-1586-1001.dcm.png,a patchy infiltrate has developed in the right middle lobe . left lung is clear . heart size normal . aorta tortuous . 
3148,3313_IM-1586-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
3149,3314_IM-1586-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3150,3315_IM-1586-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
3151,3316_IM-1586-1001.dcm.png,heart size is normal . no focal airspace disease . emphysema . bibasilar pleural scarring . no pneumothorax or effusion . 
3152,3317_IM-1587-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . "
3153,3318_IM-1587-1001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are otherwise clear . bony structures are intact . 
3154,3319_IM-1588-1001.dcm.png,"heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . multilevel degenerative changes are noted within the thoracic spine . "
3155,3320_IM-1588-1001.dcm.png,unknown
3156,3321_IM-1588-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
3157,3322_IM-1588-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . no change in a small calcified right apical granuloma . heart and mediastinum normal . 
3158,3324_IM-1590-1001.dcm.png,"the heart is normal in size . atherosclerotic calcifications of the aorta . the mediastinum is stable . there is again soft tissue density projected over the right mid chest , patient's known large breast mass . the appearance is grossly stable to decreased from prior study . the lateral projection is suboptimal as patient could not raise xxxx . there is no pleural effusion . "
3159,3325_IM-1591-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3160,3326_IM-1592-4004.dcm.png,unknown
3161,3327_IM-1593-2001.dcm.png,there is enlargement of the cardiac silhouette . there is a focal opacity within the right upper lung . there is dense calcification of the thoracic aorta . there is no pneumothorax . there is no large pleural effusion . 
3162,3328_IM-1594-1001.dcm.png,unknown
3163,3329_IM-1594-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3164,3330_IM-1594-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3165,3331_IM-1595-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . calcified right lower lobe granuloma the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . degenerative changes of the spine . "
3166,3332_IM-1596-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . low lung volumes . no focal airspace disease . no large pleural effusion or pneumothorax . the are intact . 
3167,3333_IM-1597-1001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures appear intact . the trachea and pulmonary bronchi are unremarkable . "
3168,3334_IM-1598-1001.dcm.png,unknown
3169,3335_IM-1598-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
3170,3336_IM-1598-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are several age-indeterminate left-sided rib fractures noted . there is a calcified right hilar lymph node . there basilar calcified granulomas . there minimal degenerative changes of the spine . "
3171,3337_IM-1598-1001.dcm.png,"chest . lungs are clear and expanded . heart size normal . a calcified pleural plaque in the right subpulmonic area has not since the abdomen ct . left and right knees . xxxx , spaces , and soft tissues are normal . "
3172,3338_IM-1599-2001.dcm.png,unknown
3173,3339_IM-1599-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . osseous structures are intact . 
3174,3340_IM-1601-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . atherosclerosis of the aortic xxxx . minimal densities , left lung base . hyperexpanded lungs . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
3175,3341_IM-1602-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3176,3342_IM-1603-1001.dcm.png,the patchy right lower lobe and left lower lobe interstitial infiltrates are largely unchanged in the interval . no infiltrates . heart size remains large . tracheostomy tube remains in the trachea . a right central line has its tip at the superior xxxx . 
3177,3343_IM-1603-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
3178,3344_IM-1603-1001.dcm.png,unknown
3179,3345_IM-1603-1001.dcm.png,"no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . heart size and pulmonary vascularity within normal limits , visualized osseous structures appear intact . "
3180,3346_IM-1604-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3181,3347_IM-1605-4004.dcm.png,"the lungs and pleural spaces show no acute abnormality . lower lung volumes on the ap projection . heart size is upper limits of normal , pulmonary vascularity within normal limits . implantable cardiac are visualized on the lateral projection in the region of the expected location of the mitral valve xxxx . sternotomy noted . "
3182,3348_IM-1605-1001.dcm.png,stable cardiomegaly . the lungs are clear . stable left lung base calcifications . no focal consolidations . no pneumothorax or pleural effusions . the are intact . 
3183,3349_IM-1606-1001.dcm.png,the lungs are hyperexpanded consistent with emphysema . pectus carinatum is noted . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . calcified granuloma are noted . vascular calcification is noted . 
3184,3350_IM-1607-0001-0001.dcm.png,the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of a large pleural effusion . there is no evidence of pneumothorax . 
3185,3352_IM-1608-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
3186,3354_IM-1609-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . hyperinflated lungs with flattening of diaphragms , compatible with emphysema . no focal consolidation , pleural effusion or pneumothorax . no acute bony abnormality . "
3187,3355_IM-1609-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are hyperexpanded . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
3188,3356_IM-1610-1001.dcm.png,"the lungs are clear bilaterally without focal consolidation , pneumothorax , or effusion . calcified granuloma noted in the right midlung . the heart size is within normal limits . no acute bony abnormality is identified . "
3189,3357_IM-1610-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3190,3358_IM-1611-1001.dcm.png,unknown
3191,3359_IM-1612-3001.dcm.png,heart size normal . no focal airspace disease . no pneumothorax or effusions . 
3192,3359_IM-1612-4001.dcm.png,heart size normal . no focal airspace disease . no pneumothorax or effusions . 
3193,3360_IM-1613-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . left basilar subsegmental atelectasis versus scar noted . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3194,3361_IM-1614-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
3195,3362_IM-1615-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size is upper limits of normal , pulmonary vascularity within normal limits . . "
3196,3363_IM-1616-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . the lungs are grossly clear . opacities in the lung bases . there are fragments overlying the posterior left chest , right neck base and fragments in the left costophrenic xxxx . there is no pleural effusion or pneumothorax . "
3197,3364_IM-1617-2001.dcm.png,unknown
3198,3365_IM-1618-1001.dcm.png,no large pleural effusions . no pneumothorax . no focal airspace opacities . heart size is normal . 
3199,3366_IM-1618-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3200,3367_IM-1619-3001.dcm.png,unknown
3201,3368_IM-1620-0001-0002.dcm.png,the trachea is midline . the cardiomediastinal silhouette is normal . low lung volumes causing mild bronchovascular crowding . no focal airspace consolidation is seen . there is no pleural effusion . there is no large pneumothorax . visualized bony structures reveal no acute abnormalities . pression: low lung volumes without acute cardiopulmonary findings . . 
3202,3369_IM-1621-1001.dcm.png,a large pleural air collection is present on the right . mediastinum is shifted to the left as compared to the previous examination . the right lower lobe is totally opaque . 
3203,3370_IM-1622-2001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissues unremarkable . "
3204,3371_IM-1623-1001.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . calcified right hilar lymph noted . "
3205,3372_IM-1623-1001.dcm.png,unknown
3206,3373_IM-1623-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
3207,3374_IM-1624-1001.dcm.png,"lungs are free of infiltrates . however , in the left lower lobe there is a 1 cm diameter nodule that is not calcified . the right lung is clear . the heart , xxxx , and mediastinum are normal . "
3208,3375_IM-1624-1001.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . there are degenerative changes of the midthoracic spine . 
3209,3375_IM-1624-1002.dcm.png,heart size is within normal limits . no focal airspace consolidations . no pneumothorax or pleural effusion . there are degenerative changes of the midthoracic spine . 
3210,3377_IM-1626-1002001.dcm.png,pa and lateral views were obtained . lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
3211,3378_IM-1627-1001.dcm.png,there is a moderate right-sided pneumothorax measuring approximately 3 . 3 cm in the right apex . there is a minimally displaced right lateral 8th rib fracture and probable nondisplaced right lateral 7th rib fracture . cardiomediastinal silhouette is within normal limits . left lung is clear . 
3212,3379_IM-1627-2001.dcm.png,no pneumothorax or large pleural effusion . borderline cardiomegaly . minimal retrocardiac airspace disease . bony structures appear intact . 
3213,3380_IM-1628-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there minimal degenerative changes of the spine . "
3214,3381_IM-1628-1001.dcm.png,unknown
3215,3382_IM-1629-0001-0001.dcm.png,"prominent interstitial markings . there are small bilateral pleural effusions . no pneumothorax or focal consolidation . normal heart size . catheter tubing present in the upper midabdomen . there is bilateral acromioclavicular degenerative joint disease , right greater than left . "
3216,3383_IM-1630-1001.dcm.png,unknown
3217,3384_IM-1631-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3218,3385_IM-1632-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3219,3386_IM-1633-1001.dcm.png,"the trachea is midline . the cardiomediastinal silhouette appears normal . there are no acute infiltrates , effusions . there is no evidence of pneumothorax . visualized bony structures are intact with no acute abnormalities . "
3220,3387_IM-1633-1001.dcm.png,"cardiomediastinal silhouette is within normal limits . no acute bony abnormality is identified . there is slightly increased opacity of the right base compared to the left which may minimal right basilar airspace disease , in the right middle lobe . the left lung is clear . no pneumothorax or effusion identified . "
3221,3388_IM-1633-1001.dcm.png,"normal heart size and mediastinal contours . stable calcification in the left upper lobe , representing a granuloma . no focal airspace opacities . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . "
3222,3389_IM-1634-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3223,3390_IM-1636-1001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . 
3224,3390_IM-1636-3001.dcm.png,the lungs are clear . there is no focal airspace consolidation . no pleural effusion or pneumothorax . normal cardiomediastinal silhouette . 
3225,3391_IM-1637-2001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . stable left mid lung granuloma . 
3226,3392_IM-1637-1001.dcm.png,mediastinal contours are normal . lungs are clear . there is no pneumothorax or large pleural effusion . 
3227,3393_IM-1637-1001.dcm.png,"lateral view , over the lingula , there is a 7mm diameter uncalcified nodule of uncertain origin . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . mild tortuosity aorta is redemonstrated . "
3228,3394_IM-1638-1001.dcm.png,the cardiac contours are normal . scarring left base . the lungs are clear . thoracic spondylosis . 
3229,3395_IM-1639-0001-0001.dcm.png,unknown
3230,3396_IM-1640-1001.dcm.png,unknown
3231,3398_IM-1642-4004.dcm.png,"the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . chronic appearing interstitial marking . right upper lobe granuloma , stable the lungs are normally inflated and clear . degenerative changes of the spine . "
3232,3400_IM-1644-1001.dcm.png,"heart size and pulmonary vascular engorgement appear within limits of normal . mediastinal contour is unremarkable . no focal consolidation , pleural effusion , or pneumothorax identified . no convincing acute bony findings . "
3233,3401_IM-1645-1001.dcm.png,"no focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette unremarkable . stable bilateral calcified granulomas/lymph xxxx . a bullet is present in the posterior soft tissues of the left chest wall , stable compared to prior examination . "
3234,3402_IM-1646-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . scattered calcified granulomas bilaterally . no acute bony abnormalities . "
3235,3403_IM-1647-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . "
3236,3404_IM-1647-1001.dcm.png,the heart is normal in size . the mediastinum is stable . there are postsurgical changes of the left breast . the lungs are clear . 
3237,3405_IM-1647-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . mild degenerative changes are present within the spine . "
3238,3406_IM-1647-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . calcified granuloma in the left midlung . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
3239,3407_IM-1647-1001.dcm.png,"intact sternotomy and cabg markers . calcified granulomas . heart size is normal . no focal airspace consolidation , suspicious pulmonary opacity , pneumothorax , or pleural effusion . t-spine degenerative changes . "
3240,3408_IM-1648-1001.dcm.png,the cardiomediastinal contours are within normal limits . pulmonary vasculature is unremarkable . there is no focal airspace opacity . no pleural effusion or pneumothorax is seen . multiple healed bilateral rib fractures . no acute bony abnormality is identified . 
3241,3410_IM-1648-1001.dcm.png,lungs are hyperexpanded . no infiltrates or masses in the lungs . heart size normal . no change calcified left hilar and left small granuloma . 
3242,3411_IM-1649-0001-0001.dcm.png,"there are low lung volumes with bronchovascular crowding . there is patchy left lower lobe airspace disease . there are opacities in the right mid lung , subsegmental atelectasis . no significant pleural effusion . no pneumothorax . heart size is within normal limits . there is aortic atherosclerotic vascular calcification . "
3243,3412_IM-1650-1001-0001.dcm.png,the lungs are clear . there is no pneumonia . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours appear normal . bony overlap in the lung apices could obscure a small pulmonary nodule . 
3244,3413_IM-1650-1001.dcm.png,the heart and mediastinal contours are stable . the lungs are clear without focal infiltrate . there is no pleural effusion or pneumothorax . 
3245,3414_IM-1650-1001.dcm.png,heart size appears enlarged . mediastinal contours are within normal limits . lung volumes are low with central bronchovascular crowding and patchy basilar atelectasis . . osseous structures are within normal limits for patient age . 
3246,3415_IM-1650-1001.dcm.png,"no acute osseous abnormality . mild degenerative changes of the thoracic spine . stable normal cardiomediastinal silhouette and hilar contours . prominence of superior mediastinal , superimposed structures . no focal area of consolidation , pleural effusion , or pneumothorax . mild bibasilar atelectasis . "
3247,3416_IM-1651-0001-0001.dcm.png,"redemonstration of the left basilar patchy atelectasis , unchanged from last exam . lungs are otherwise clear . no evidence of pneumothorax or pleural effusions present . there is a focal calcified nodules in the left upper lung , stable in appearance from of xxxx . the cardiomediastinal silhouette is unremarkable . no suspicion bony destruction identified . "
3248,3417_IM-1652-1001.dcm.png,"the lungs are hyperexpanded , consistent with copd . mild cardiomegaly . no focal lung consolidation . no pneumothorax or pleural effusion . pulmonary vascularity is within normal limits . mild degenerative changes of the thoracic spine . aortic calcifications consistent with atherosclerotic disease . "
3249,3418_IM-1653-1001.dcm.png,prominent interstitial markings . there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . 
3250,3419_IM-1654-12012.dcm.png,unknown
3251,3419_IM-1654-4004.dcm.png,unknown
3252,3420_IM-1656-1001.dcm.png,clear lungs . heart size is normal . no pneumothorax or large pleural effusion . 
3253,3421_IM-1656-1001.dcm.png,"pa and lateral views of the chest were obtained . the cardiomediastinal silhouette is normal in size and configuration . mildly tortuous thoracic aorta . the lungs are well aerated . there is no pneumothorax , pleural effusion , or focal air space consolidation . mild elevation right hemidiaphragm . "
3254,3422_IM-1656-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3255,3423_IM-1656-1001.dcm.png,the heart size is normal . there is tortuosity of aorta . pulmonary vascularity is normal . no focal airspace disease or effusion . degenerative changes in the thoracic spine . 
3256,3424_IM-1656-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . there are multiple calcified granulomas within the left lower lobe . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
3257,3426_IM-1656-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are minimal degenerative changes of the spine . "
3258,3427_IM-1657-1001.dcm.png,the cardiac silhouette and mediastinum size are within normal limits . there is no pulmonary edema . there is no focal consolidation . there are no of a large pleural effusion . there is no evidence of pneumothorax . 
3259,3428_IM-1657-1001.dcm.png,there is a prominent calcified head to the right anterior first rib . the aorta is tortuous . there are t-spine osteophytes . the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
3260,3429_IM-1657-1001.dcm.png,"low lung volumes . heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures appear intact . left humeral head bone anchors . "
3261,3430_IM-1659-4004.dcm.png,"heart size mildly to moderately enlarged , distal tip dual-lumen catheter near the caval atrial junction . mild vascular cephalization , no definite interstitial changes of pulmonary edema , no focal alveolar consolidation . no pleural effusion demonstrated . "
3262,3431_IM-1660-1001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures grossly intact . "
3263,3432_IM-1661-1001.dcm.png,cardiomegaly is noted . no pleural effusions . no pneumothorax . there is perihilar prominence and interstitial opacification . 
3264,3433_IM-1662-1001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures intact . "
3265,3434_IM-1662-1001.dcm.png,unknown
3266,3435_IM-1662-1001.dcm.png,unknown
3267,3436_IM-1663-1001.dcm.png,the lungs appear hyperexpanded suggesting emphysema . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . calcified granuloma is identified . no pneumothorax or pleural effusion is seen . 
3268,3437_IM-1663-1001.dcm.png,"stable , normal cardiac size , mediastinum , and central pulmonary vasculature . the lungs remain grossly clear , aside from mild biapical pleural-peripheral scarring and minimal chronic interstitial changes . no focal airspace consolidation , pleural effusion , or pneumothorax . "
3269,3438_IM-1664-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3270,3439_IM-1664-1001.dcm.png,normal heart size . clear lungs . no pneumothorax or pleural effusion . 
3271,3440_IM-1665-1001.dcm.png,mild dextroscoliosis of the lower thoracic spine . cardiomediastinal silhouette is within normal in size and appearance . pulmonary vascular is unremarkable . lungs are expanded and clear airspace disease . negative for pneumothorax or pleural effusion . limited evaluation of the to be grossly intact
3272,3441_IM-1666-1001.dcm.png,"heart size and mediastinal contour within normal limits . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
3273,3442_IM-1667-1001.dcm.png,normal cardiomediastinal contours . low lung volumes with minimal left basilar opacities . no pneumothorax or pleural effusions . 
3274,3443_IM-1667-1001.dcm.png,unknown
3275,3444_IM-1667-1001.dcm.png,unknown
3276,3444_IM-1667-2001.dcm.png,unknown
3277,3445_IM-1668-1001.dcm.png,"no gross consolidation , atelectasis or infiltrate . no pleural fluid collection or pneumothorax . cardiomediastinal silhouette is within normal limits . is intact . "
3278,3446_IM-1669-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3279,3448_IM-1671-3001.dcm.png,"the lungs are hyperexpanded . the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal airspace opacities , pneumothorax or pleural effusion . a calcific density in the left midlung zone represents old granulomatous disease . no acute bony abnormalities . "
3280,3449_IM-1672-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . external monitor leads the thorax . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
3281,3450_IM-1673-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3282,3451_IM-1674-1001.dcm.png,the heart is normal in size . the mediastinum is stable . calcified ap lymph are seen . a small right-sided pleural effusion versus thickening . right inferior rib deformities . 
3283,3452_IM-1675-1001.dcm.png,"heart size and pulmonary vascularity within normal limits . no focal infiltrate , pneumothorax or pleural effusion identified . "
3284,3453_IM-1676-0001-0001.dcm.png,unknown
3285,3454_IM-1677-3001.dcm.png,unknown
3286,3455_IM-1677-1001.dcm.png,central vascular prominence and diffuse bilateral interstitial and alveolar opacities . left basilar airspace opacities . no pneumothorax . heart size large . unremarkable . no large pleural effusion . 
3287,3456_IM-1678-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . low lung volumes without focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
3288,3457_IM-1678-1001.dcm.png,unknown
3289,3458_IM-1678-1001.dcm.png,the lungs are clear . the heart pulmonary are normal . the pleural spaces are clear . mediastinal contours are normal . 
3290,3459_IM-1679-1001.dcm.png,stable appearance of lower cervical fusion xxxx . heart size normal . no pneumothorax or pleural effusion . no focal airspace disease . calcified nodules consistent with chronic granulomatous disease . bony structures appear intact . dish of the thoracic spine . 
3291,3460_IM-1681-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
3292,3461_IM-1682-1001.dcm.png,clear lungs . no pneumothorax . no pleural effusion . normal heart . trachea is midline . 
3293,3462_IM-1683-1001.dcm.png,the heart is top normal in size . the mediastinum is stable . there is a small retrocardiac density which may be secondary to small hiatal hernia . left ij catheter tip at cavoatrial junction . no pneumothorax is seen . the lungs are clear . 
3294,3464_IM-1683-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3295,3465_IM-1683-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . 
3296,3466_IM-1683-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . streaky perihilar opacities . peribronchial cuffing also noted . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
3297,3467_IM-1684-0001-0001.dcm.png,the lungs are clear . the heart and pulmonary are normal . pleural spaces are clear . the mediastinal contours are normal . there is calcification of the thoracic aorta . 
3298,3468_IM-1684-0001-0003.dcm.png,"heart size is at the upper limits of normal . there is aortic atherosclerotic vascular calcification . the lungs remain hyperexpanded . there are biapical opacities , stable from the prior study . no focal airspace consolidation . no significant pleural effusion . no pneumothorax . there are mild degenerative changes of the spine . "
3299,3468_IM-1684-0001-0004.dcm.png,"heart size is at the upper limits of normal . there is aortic atherosclerotic vascular calcification . the lungs remain hyperexpanded . there are biapical opacities , stable from the prior study . no focal airspace consolidation . no significant pleural effusion . no pneumothorax . there are mild degenerative changes of the spine . "
3300,3469_IM-1685-1001.dcm.png,"normal heart size and pulmonary vascularity . there are changes of chronic lung disease noticed by hyperinflated lungs and streaky opacities compatible with scar . interval placement of the chest with the tip in the superior xxxx . no focal infiltrate , pneumothorax or pleural effusion is identified . "
3301,3470_IM-1686-1001.dcm.png,the patient is rotated . the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no pneumothorax or pleural effusion . no focal airspace opacities . mild degenerative changes of the thoracic spine . 
3302,3471_IM-1687-2002.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . there is a rounded lucency seen above the diaphragm on lateral view , suggestive of small hiatal hernia . visualized osseous structures appear intact . degenerative changes of the thoracic spine seen . "
3303,3472_IM-1688-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
3304,3473_IM-1688-2002.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . no discrete nodules or adenopathy are noted . 
3305,3474_IM-1688-1001.dcm.png,"crowded bronchovascular markings in the hilar and perihilar region , right lower lung zones . low lung volumes . no noncalcified pulmonary nodules seen . no pleural effusion or pneumothorax . no small heart size . there is a right diaphragmatic hump . the soft tissues seen in the left cardiophrenic xxxx , could represent an ectatic descending aorta or hiatal hernia . visualized of the chest are within normal limits . degenerative changes demonstrated within the visualized thoracic spine . "
3306,3475_IM-1688-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3307,3477_IM-1690-3001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . no evidence of active tuberculosis . 
3308,3478_IM-1690-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . scoliosis . 
3309,3479_IM-1690-1001.dcm.png,soft tissue neck . the airway is xxxx . no laryngeal edema . laryngeal intact . cervical spine intact . chest . the heart is large . diffuse parahilar and alveolar consolidations are present . bilateral costophrenic blunting is present . 
3310,3480_IM-1691-1001.dcm.png,the cardiomediastinal silhouette and pulmonary vasculature are within normal limits . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . cholecystectomy clips are present . 
3311,3481_IM-1692-1001.dcm.png,"the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . lungs are hyperexpanded without focal airspace consolidation , pleural effusion , or pneumothorax . . degenerative endplate changes of the spine . . "
3312,3482_IM-1692-1001.dcm.png,severe emphysematous disease is again noted . multifocal areas of scarring are unchanged in appearance . no pneumothorax . heart size is normal . 
3313,3483_IM-1692-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
3314,3485_IM-1694-2002.dcm.png,the heart size and pulmonary vascular appear within normal limits . the lungs appear hyperexpanded consistent with emphysema . calcified lymph and granuloma are noted . no acute appearing focal airspace disease is seen . no pleural effusion or pneumothorax is noted . 
3315,3486_IM-1695-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . mild chronic degenerative changes are present in the spine . "
3316,3487_IM-1696-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . . 
3317,3488_IM-1696-4004.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . degenerative changes of the spine . . 
3318,3489_IM-1696-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
3319,3490_IM-1697-1001.dcm.png,unknown
3320,3491_IM-1698-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the thoracic aorta is prominent with calcification within the aorta . azygos lobe is noted . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes noted in the spine . 
3321,3492_IM-1698-1001.dcm.png,the lungs remain hyperexpanded . no masses or infiltrates in the lungs . no pleural or mediastinal air collections . heart size normal . 
3322,3493_IM-1698-1001.dcm.png,heart size is within normal limits . trachea is midline . the lung volumes are slightly on the low side . lungs are otherwise clear without pleural effusion or pneumothorax . no focal consolidations . no bony or soft tissue abnormalities . 
3323,3494_IM-1699-1001.dcm.png,there are low lung volumes with bronchovascular crowding . there is no focal consolidation . no visualized pneumothorax . heart size is within normal limits . the cardiomediastinal contours is grossly normal in size and contour . 
3324,3495_IM-1700-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3325,3495_IM-1700-3001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3326,3498_IM-1702-1001.dcm.png,"chest . a minimally displaced fracture is present on right rib 4 . the small amount of pleural fluid is deep to the fracture . no pleural air collection . both lungs clear and expanded . heart and mediastinum normal . note of a levoscoliosis of the thoracolumbar spine . right shoulder . xxxx , soft tissues , and alignment are normal . right humerus . and soft tissues are intact . "
3327,3499_IM-1703-2002.dcm.png,unknown
3328,3500_IM-1706-1001.dcm.png,"frontal and lateral views demonstrate the cardiomediastinal silhouette to be within normal limits . there is normal distribution of the pulmonary vascularity . the lungs are clear . no effusion , consolidation , or pneumothorax . "
3329,3501_IM-1706-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , pleural effusion , or pneumothorax is identified . no acute osseous abnormality identified . "
3330,3502_IM-1707-1001.dcm.png,"there has been interval performance of cabg with multiple sternotomy xxxx , surgical clips , and cabg markers . all of the sternotomy are broken , and a fragment at a sternotomy appears to within the left posterior pleural space . stable cardiomegaly and central pulmonary vascular prominence . no focal consolidation , pneumothorax , or effusion . relative elevation of the left hemidiaphragm noted . no acute bony abnormality . "
3331,3503_IM-1707-3001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
3332,3504_IM-1707-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3333,3505_IM-1707-1001.dcm.png,heart size is normal and the lungs are clear . 
3334,3506_IM-1708-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3335,3507_IM-1709-4004.dcm.png,"cardiac and mediastinal appear normal . no visible pneumothorax , focal airspace opacity , or pleural effusion is seen . no visible free air under the diaphragm . the osseous structures appear intact . there is a mild dextro scoliotic curvature of the midthoracic spine . "
3336,3508_IM-1710-1001.dcm.png,the heart is normal in size . the cardiomediastinal contours are stable . there are stable bilateral pleural effusions with partial right-sided loculation . biapical scarring and pleural thickening appears stable . there is again right-sided superior hilar retraction and mild rightward deviation . no acute infiltrate is appreciated . 
3337,3509_IM-1711-0001-0001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . right pleural effusion is present and appears increased . no pneumothorax is identified . some scattered of right base atelectasis are seen . surgical remain in xxxx . the left lung appears clear . 
3338,3509_IM-1711-0001-0003.dcm.png,the heart size and pulmonary vascularity appear within normal limits . right pleural effusion is present and appears increased . no pneumothorax is identified . some scattered of right base atelectasis are seen . surgical remain in xxxx . the left lung appears clear . 
3339,3510_IM-1713-4004.dcm.png,unknown
3340,3511_IM-1714-1001.dcm.png,unknown
3341,3512_IM-1714-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . thoracic spondylosis . 
3342,3513_IM-1715-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
3343,3514_IM-1715-2001.dcm.png,no focal lung consolidation . a density overlying the left costophrenic is due to overlying soft tissues . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
3344,3515_IM-1715-1001.dcm.png,lungs are clear . a calcified small granuloma is present in the left lower lobe . heart size normal . mediastinum normal . 
3345,3516_IM-1715-1001.dcm.png,normal heart size and mediastinal contours . minimal blunting of the costophrenic xxxx . no focal airspace consolidation . no pneumothorax or pleural effusion . 
3346,3518_IM-1717-1001.dcm.png,"the heart and mediastinal silhouettes are within normal limits . the lungs are clear without focal airspace opacity , large effusion , or pneumothorax . the are grossly intact . degenerative t-spine osteophytes . "
3347,3519_IM-1717-1001.dcm.png,large left lower lobe opacity is present . there does not appear to be significant mediastinal shift . there is no pneumothorax . the cardiac silhouette is not definitively identified and not fully evaluated . the mediastinal contours are unremarkable . 
3348,3520_IM-1718-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . minimal streaky atelectasis the left lung base . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . thoracic spondylosis . "
3349,3521_IM-1719-4001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . there is right greater than left biapical bullous emphysema . no focal consolidation , pleural effusion , or pneumothorax identified . there are degenerative changes of the thoracic spine . "
3350,3522_IM-1720-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
3351,3523_IM-1721-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . no change right anterior soft tissue surgical clips . configuration of breast shadows on the pa view suggests prior right lumpectomy . 
3352,3524_IM-1721-1001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
3353,3525_IM-1722-6001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . the visualized bony structures appear intact . there is a radiodensity overlying the right shoulder which is external to the patient however clinical correlation recommended . scattered calcified granulomas . "
3354,3526_IM-1723-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . there are diminished lung volumes with hypoventilatory changes . the cardiac silhouette is not enlarged . there is mild tortuosity of the thoracic aorta . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . surgical clips are seen in the upper abdomen . no acute osseous abnormalities demonstrated . "
3355,3527_IM-1724-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3356,3528_IM-1725-2002.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3357,3529_IM-1725-1001.dcm.png,status post midline sternotomy with intact xxxx . stable mild cardiomegaly . normal lung vascularity . the lungs are clear . 
3358,3530_IM-1726-1001.dcm.png,unknown
3359,3531_IM-1726-1001.dcm.png,normal heart size . mild unfolding of the thoracic aorta . no focal airspace opacity . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . 
3360,3532_IM-1726-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3361,3532_IM-1726-3001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3362,3533_IM-1726-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . there is bilateral hyperinflation , without focal consolidation , pneumothorax , or pleural effusion . visualized osseous structures appear intact . "
3363,3534_IM-1727-1001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . heart size is normal . stable right paratracheal prominence , consistent with known calcified lymph node , seen on prior ct chest dated xxxx . are unremarkable . "
3364,3535_IM-1728-0001-0002.dcm.png,the lungs are clear . the heart and pulmonary are normal . pleural spaces are clear . mediastinal contours are normal . 
3365,3536_IM-1729-4004.dcm.png,"heart size is enlarged , pulmonary vascularity within normal limits . no visible pneumothorax . right pleural effusion blunting posterior costophrenic xxxx . there is a of subsegmental atelectasis of the left lung base . there is alveolar airspace disease in the medial right lung base . multilevel degenerative disease of the visualized portions of the thoracolumbar spine . "
3366,3537_IM-1730-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3367,3538_IM-1731-1001.dcm.png,unknown
3368,3539_IM-1731-1001.dcm.png,normal heart size . the lungs are clear without pneumothorax or large pleural effusion . the trachea is midline and xxxx . 
3369,3540_IM-1732-1001.dcm.png,the heart and mediastinum are unremarkable . the lungs are hyperexpanded . the lungs are clear without infiltrate . there is no effusion or pneumothorax . 
3370,3541_IM-1733-0001-0002.dcm.png,lung volumes are mildly decreased . the cardiac silhouette and pulmonary vascularity are normal . there is bilateral lower lobe airspace opacities compatible with discoid atelectasis . there is no evidence of pleural effusion or pneumothorax . 
3371,3542_IM-1734-1001.dcm.png,"heart size and mediastinal contours appear within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , suspicious pulmonary opacity , pneumothorax or definite pleural effusion . visualized osseous structures appear intact . "
3372,3543_IM-1735-2001.dcm.png,"heart size and mediastinal contour within normal limits . multiple calcified granulomas in the bilateral and lung parenchyma . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
3373,3544_IM-1736-1001.dcm.png,cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . opacities reflecting atelectasis versus bronchovascular crowding . 
3374,3545_IM-1737-2002.dcm.png,opacities in the lung bases are slightly worse compared to prior study . lung volumes are low . heart size and pulmonary are normal . there no focal airspace opacities to suggest pneumonia . the patient is status post sternotomy . there calcifications of the thoracic aorta . 
3375,3546_IM-1738-4004.dcm.png,unchanged cardiomegaly . there is continued interstitial prominence bilaterally . unchanged vascular appearance . there is patchy retrocardiac opacity . negative for pneumothorax . 
3376,3547_IM-1739-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . degenerative changes in the thoracic spine . 
3377,3548_IM-1739-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
3378,3549_IM-1739-1001-0001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3379,3549_IM-1739-1001-0002.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3380,3550_IM-1740-1001.dcm.png,"normal heart size . prominent contour of the ascending aorta , consistent with ectasia . normal mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . minimal degenerative changes of the thoracic spine . "
3381,3551_IM-1740-12012.dcm.png,"heart size near top normal limits for technique . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . dense left lower lobe nodule suggests a previous granulomatous process . "
3382,3552_IM-1741-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
3383,3553_IM-1741-1001.dcm.png,unknown
3384,3555_IM-1741-2001.dcm.png,the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . degenerative disease of multiple midthoracic vertebral bodies . 
3385,3556_IM-1741-1001-0001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . there has been a sternotomy . the heart is not enlarged . some atherosclerotic changes of the aorta are seen . the skeletal structures are normal . 
3386,3557_IM-1742-0001-0002.dcm.png,left picc line and ng tube remain in xxxx . heart size and vascularity appear within normal limits . the lungs are free of focal airspace disease . small bilateral pleural effusions are present . no pneumothorax is noted . 
3387,3559_IM-1744-1001.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . mild levocurvature of thoracic spine . a 9 mm pulmonary nodule is noted partially overlying the posterior 6th right rib on the frontal view . "
3388,3560_IM-1745-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3389,3561_IM-1746-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3390,3562_IM-1747-2001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . sequela of prior granulomatous disease lung volumes are low with central bronchovascular crowding and patchy basilar atelectasis . . degenerative changes of the spine . 
3391,3563_IM-1748-2002.dcm.png,unknown
3392,3564_IM-1749-0001-0001.dcm.png,the heart is top normal in size . the mediastinum is stable . surgical clips again seen overlying the superior mediastinum . there is an retrocardiac density compatible hiatal hernia . the lungs are mildly hypoinflated . no acute infiltrate or pleural effusion are seen . 
3393,3565_IM-1750-1001.dcm.png,the cardiomediastinal silhouette is stable in appearance . there is redemonstration of complete opacification of the right middle lobe no significant associated volume loss . the left lung appears clear . no pneumothorax or pleural effusion demonstrated . the thoracic spine appears intact . 
3394,3566_IM-1751-12012.dcm.png,normal heart size and mediastinal contours . low lung volumes mild bibasilar atelectasis . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . the lateral views are limited by patient positioning and motion . large cervical spine osteophytes . 
3395,3566_IM-1751-4004.dcm.png,normal heart size and mediastinal contours . low lung volumes mild bibasilar atelectasis . no focal airspace consolidation . no pleural effusion or pneumothorax . visualized osseous structures are unremarkable in appearance . the lateral views are limited by patient positioning and motion . large cervical spine osteophytes . 
3396,3568_IM-1753-1001.dcm.png,"the heart size is normal with stable appearance of the cardiomediastinal silhouette . the lungs are clear without focal airspace opacity , pleural effusion , or pneumothorax . there are stable calcified right peritracheal lymph xxxx . the osseous structures are intact . "
3397,3569_IM-1753-1001.dcm.png,normal heart size and mediastinal contours . low lung volumes . no focal airspace consolidation . no pneumothorax or pleural effusion . 
3398,3570_IM-1754-1001.dcm.png,normal heart size mediastinal contours . subsegmental atelectasis versus scarring in the right midlung and left lower lobe . no focal airspace disease . no pleural effusion or pneumothorax . low lung volumes . visualized bony structures are unremarkable in appearance . 
3399,3570_IM-1754-3001.dcm.png,normal heart size mediastinal contours . subsegmental atelectasis versus scarring in the right midlung and left lower lobe . no focal airspace disease . no pleural effusion or pneumothorax . low lung volumes . visualized bony structures are unremarkable in appearance . 
3400,3571_IM-1754-3001.dcm.png,heart size and pulmonary vascularity normal . the stomach contour normal . there is right hemidiaphragm elevation . lungs are clear . degenerative changes in the thoracic spine . 
3401,3572_IM-1755-84853001.dcm.png,unknown
3402,3573_IM-1756-1001.dcm.png,the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is mildly tortuous and calcified . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . mild degenerative changes of the thoracic spine . mild levoscoliosis of the thoracolumbar spine . 
3403,3574_IM-1756-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . suspected artifact over the bilateral neck soft tissues and supraclavicular fossae . normal xxxx . "
3404,3575_IM-1757-1001.dcm.png,"heart size normal . no pneumothorax , pleural effusion , or focal airspace disease . central left midlung granuloma with calcified left hilar adenopathy . bony structures appear intact . "
3405,3576_IM-1757-1001.dcm.png,the cardiomediastinal silhouette is within normal limits . the lungs are clear without areas of focal consolidation . no pneumothorax or large pleural effusion . no acute bone abnormality . 
3406,3577_IM-1758-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . no evidence of pneumothorax . osseous structures intact . 
3407,3578_IM-1758-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3408,3579_IM-1759-1001.dcm.png,interval resolution of the left pleural effusion . lungs are grossly clear . postsurgical changes from cabg are noted . no pneumothorax or pleural effusion . no acute bony abnormalities are visualized . 
3409,3580_IM-1760-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
3410,3581_IM-1761-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . pectus carinatum is noted . calcified lymph and granuloma are noted . no pleural effusion or pneumothorax is seen . mild deformity is noted in the lower thoracic spine . 
3411,3582_IM-1761-1001.dcm.png,heart size is normal . the lungs are clear . there is no pneumothorax or large pleural effusion . 
3412,3583_IM-1762-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are mild degenerative changes of the spine . "
3413,3585_IM-1763-1001.dcm.png,unknown
3414,3586_IM-1764-1001.dcm.png,the heart is mildly enlarged . the mediastinal contours are stable . the lungs are clear . 
3415,3587_IM-1765-1001.dcm.png,the lungs are clear . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3416,3588_IM-1766-1001.dcm.png,and lateral chest examination was obtained . the heart silhouette is normal in size and contour . aortic appear unremarkable . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
3417,3589_IM-1767-1001.dcm.png,cardiomediastinal contour and pulmonary vascularity stable and within normal limits . lung volumes are slightly low . there are streaky left basal opacities . no pleural effusion or pneumothorax . no acute osseous findings . no free air is demonstrated . 
3418,3590_IM-1769-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . no pneumothorax . "
3419,3591_IM-1770-1001-0001.dcm.png,the heart and mediastinal contours are unchanged . there is a moderate hiatal hernia . the lungs are clear without focal infiltrate . no effusion or pneumothorax . 
3420,3592_IM-1771-1001.dcm.png,unknown
3421,3593_IM-1772-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3422,3594_IM-1772-1001.dcm.png,the cardiomediastinal silhouette is normal . no focal airspace consolidation . no pneumothorax or pleural effusion . 
3423,3595_IM-1773-0001-0001.dcm.png,"stable cardiomegaly and mediastinal contour . increased interstitial lung markings are seen , possibly due to volume overload . there is improved aeration of the lung bases with small residual left basilar effusion . no focal consolidation or pneumothorax . stable tunneled dialysis catheter . visualized osseous structures appear intact . "
3424,3596_IM-1774-1001.dcm.png,unknown
3425,3597_IM-1775-1001.dcm.png,"left noted with tip approximating the high svc , stable . no pleural effusions . no pneumothorax . heart size is normal limits . degenerative changes thoracic spine . "
3426,3598_IM-1775-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . convexity also present on the previous exam . "
3427,3599_IM-1775-1001.dcm.png,"there are intact midline sternotomy and postsurgical changes of prior cabg . the aorta is unfolded . the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are mild degenerative changes in the thoracic spine . "
3428,3600_IM-1776-4004.dcm.png,unknown
3429,3601_IM-1777-2002.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . large hiatal hernia is present . osteopenia and degenerative changes are present in the spine . vascular calcification is noted . degenerative changes are present in the right shoulder . 
3430,3602_IM-1778-1001.dcm.png,"normal cardiomediastinal silhouette and hilar contours . calcified bilateral lung and perihilar granulomas . the lungs are clear without focal area of consolidation , pleural effusion , or pneumothorax . . are intact without acute osseous abnormality . "
3431,3603_IM-1779-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3432,3604_IM-1780-0001-0001.dcm.png,unknown
3433,3605_IM-1781-1001.dcm.png,heart size within normal limits . no focal airspace disease . no pleural effusion . 
3434,3606_IM-1781-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3435,3607_IM-1781-1001.dcm.png,"heart size and pulmonary vascularity appear within normal limits . the patient is status post cabg . a few opacities are present in the left base , the appearance which scarring or atelectasis . no pneumothorax or pleural effusion is seen . degenerative changes are present in the spine . "
3436,3608_IM-1781-1001.dcm.png,chest: the heart is enlarged . there may be a pericardial effusion . no definite pulmonary edema is seen . lungs appear clear . there is no pleural effusion . the skeletal structures and soft tissues are unremarkable . kub xxxx: single view of the abdomen was obtained . the bowel pattern is nonspecific . there is no evidence for obstruction or free intraperitoneal air . no large soft tissue masses or organomegaly are identified . the skeletal structures appear normal . 
3437,3609_IM-1782-2001.dcm.png,there is borderline cardiomegaly . mediastinum and pulmonary vasculature are unremarkable . lungs are clear . no pleural fluid or pneumothorax is appreciated . 
3438,3610_IM-1783-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3439,3611_IM-1784-0001-0001.dcm.png,stable appearance of the cardiomediastinal silhouette . the aorta is calcified and tortuous . there is dextroscoliosis of the thoracolumbar spine . multiple thoracic deformities appear unchanged . there is no displaced rib fracture identified . there is no pneumothorax or large pleural effusion . stable changes of chronic lung disease with flattening of the left hemidiaphragm . there is mild right basilar airspace disease which may represent atelectasis versus infiltrate . 
3440,3612_IM-1785-1001.dcm.png,the heart is normal in size . the mediastinum is stable . calcified right paratracheal lymph are seen . aorta is atherosclerotic . the lungs are mildly hypoinflated without focal consolidation . there is no pleural effusion . 
3441,3613_IM-1786-2002.dcm.png,unknown
3442,3614_IM-1787-4001.dcm.png,ap and lateral views were obtained . bibasilar atelectasis and small left-sided pleural effusion . stable cardiomegaly . no pneumothorax . mild pulmonary vascular congestion . 
3443,3615_IM-1788-1001.dcm.png,unknown
3444,3616_IM-1789-2002.dcm.png,"the heart is normal in size . the mediastinum is stable . the aorta is atherosclerotic . there are emphysematous changes with increased interstitial markings , particularly in the periphery and lung bases . the lungs are clear of focal infiltrates . there is no pleural effusion . "
3445,3617_IM-1789-1001.dcm.png,the cardiac silhouette and mediastinal contours are within normal limits . there is no focal opacity . there is no pneumothorax . there is no large pleural effusion . 
3446,3618_IM-1790-82420001.dcm.png,the heart size and mediastinal silhouette are within normal limits . no pneumothorax or pleural effusions . the lungs are clear . no focal consolidations . the osseous structures are intact . 
3447,3619_IM-1791-1001.dcm.png,"cardiac and mediastinal appear normal . no visible pneumothorax , focal airspace opacity , or pleural effusion is seen . no visible free air under the diaphragm . the osseous structures appear intact . "
3448,3620_IM-1791-1001-0001.dcm.png,"the cardiac silhouette is near upper limits of normal in size . pulmonary vasculature is normal in caliber . there is minimal atelectasis or scar in the left lung base . the lungs are otherwise grossly clear . there is a small calcified granuloma in the left upper lobe . there is no pneumothorax or pleural effusion . no acute , displaced rib fractures are demonstrated . "
3449,3621_IM-1792-3001.dcm.png,lung volumes remain low . no infiltrates . heart and pulmonary are normal . 
3450,3623_IM-1793-1001.dcm.png,soft tissue and bony structures unremarkable . heart size is upper limit of normal . lung are clear . no effusion or pneumothorax . calcified lymph stable from prior exam . 
3451,3624_IM-1794-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
3452,3625_IM-1794-1001.dcm.png,the lungs appear clear . there are no suspicious pulmonary nodules or masses . the heart and pulmonary appear normal . mediastinal contours appear normal . there's no pneumothorax . 
3453,3626_IM-1794-1001.dcm.png,unknown
3454,3628_IM-1796-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . there are multilevel degenerative changes of the thoracic spine . "
3455,3629_IM-1797-1001.dcm.png,unknown
3456,3630_IM-1798-4004.dcm.png,"frontal and lateral views of the chest show normal size and configuration of the cardiac silhouette . there is aortic vascular calcification . and there is a hyper left lung calcified granuloma . normal mediastinal contour , pulmonary and vasculature , central airways and lung volumes . no pleural effusion . there are vascular and skeletal senescent changes . "
3457,3631_IM-1798-4004.dcm.png,unknown
3458,3632_IM-1799-2001.dcm.png,"normal heart size and mediastinal contours . calcified aortic xxxx . opacities in the left lung base , atelectasis . the lateral view shows a left pleural effusion . no focal airspace consolidation . no pneumothorax . stable bilateral apical pleural capping . "
3459,3633_IM-1800-1001.dcm.png,degenerative changes of the thoracic spine . heart size normal . lungs are clear . no pneumothorax or pleural effusion . low lung volumes . 
3460,3634_IM-1801-1001.dcm.png,"stable cardiomediastinal silhouette . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . "
3461,3635_IM-1802-1001.dcm.png,"stable cardiomediastinal silhouette . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . there are stable degenerative changes of the spine . "
3462,3636_IM-1803-1001.dcm.png,"normal cardiomediastinal silhouettes . mild hyperexpansion of the lungs . stable appearance of scarring at lung bases . prominent bilateral interstitial opacities are chronic in xxxx . no focal consolidation , pleural effusion , or pneumothorax . no acute osseous abnormality . "
3463,3637_IM-1804-1001.dcm.png,"heart size within normal limits , stable mediastinal and hilar contours . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
3464,3638_IM-1804-1001.dcm.png,cardiomegaly . no pneumothorax or pleural effusion . clear lung bilaterally . 
3465,3639_IM-1804-1002001.dcm.png,the cardiac and mediastinal silhouette is normal there is no evidence of pneumomediastinum or pneumothorax . clear lungs there are no large pleural effusions no evidence of displaced fractures . 
3466,3640_IM-1804-1001.dcm.png,unknown
3467,3641_IM-1805-1001.dcm.png,"heart size within normal limits , stable mediastinal contours , mediastinal clips , left base pleural-parenchymal irregularity compatible with scarring . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . chronic appearing left rib contour irregularities may be posttraumatic or postsurgical . "
3468,3642_IM-1806-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . mild degenerative changes of the thoracic spine . degenerative changes of the xxxx . tortuous aorta . 
3469,3643_IM-1806-1001.dcm.png,unknown
3470,3644_IM-1807-1001.dcm.png,"stable xxxx , including elongation of the left ventricle and tortuous thoracic aorta . subcarinal calcified lymph xxxx . lung volumes . no focal consolidation , pneumothorax or large pleural effusion . negative for acute bone abnormality . "
3471,3646_IM-1808-0001-0002.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . 
3472,3647_IM-1809-1001.dcm.png,lungs are clear . heart is normal size . trachea is midline . no pneumothorax . no large pleural effusion . 
3473,3648_IM-1810-3001.dcm.png,"the heart and cardiomediastinal silhouette are normal in size and contour . there is no focal airspace opacity , pleural effusion , or pneumothorax . the osseous structures are intact . "
3474,3649_IM-1811-3001.dcm.png,clear lungs bilaterally . no pneumothorax or large pleural effusion . normal cardiac contour . 
3475,3650_IM-1813-1001.dcm.png,the heart is not enlarged . the bilateral pulmonary arteries appear enlarged . the lungs are hyperexpanded the hemidiaphragms are flattened . there is no pneumothorax or pleural effusion . there are no focal areas of consolidation . 
3476,3651_IM-1813-1001.dcm.png,blunting of the costophrenic represents scarring . no pleural effusion is identified on the lateral view . there is no focal consolidation . no pneumothorax is present . the cardiomediastinal silhouette is within normal limits are in the pulmonary vasculature is normal . 
3477,3652_IM-1814-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . are intact . there are calcified right hilar granulomas . there is mild thoracic dextroscoliosis . "
3478,3653_IM-1815-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . there are diminished lung volumes with atelectasis . the cardiac silhouette is unchanged . there is mild to moderate tortuosity of the thoracic aorta . no focal consolidation , pleural effusion , or pneumothorax identified . thoracic spondylosis is again seen . "
3479,3654_IM-1816-1001.dcm.png,there is a 6 mm nodular opacity in the right upper lobe . this appears from the prior study . the lungs otherwise appear clear . no pleural effusion or pneumothorax is seen . heart size and mediastinal contour appear within normal limits . 
3480,3655_IM-1817-1001.dcm.png,"well circumscribed 11 mm right upper lobe nodule , unchanged appearance from previous examination 7 years ago . the trachea is midline . negative for pneumothorax , pleural effusion . the heart size is normal . redemonstrated syndesmophyte . "
3481,3656_IM-1817-1001.dcm.png,heart size borderline enlarged . stable cardiomediastinal silhouette . no pneumothorax or large pleural effusion . no focal airspace disease . low lung volumes . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . mild degenerative disease of the thoracic spine . 
3482,3657_IM-1818-1001.dcm.png,the heart size is normal . there is vascular congestion in bilateral hilar areas . the lungs are hyperexpanded with flattened diaphragms . no acute bony abnormalities . no effusion or infiltrate . no pneumothorax or pneumomediastinum . 
3483,3658_IM-1819-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . biapical fibronodular pleural thickening/scarring . there is a like deformity of the anterior cortex of the body ( lateral view ) . negative for retrosternal density . prior cholecystectomy . critical result notification documented through primordial . "
3484,3659_IM-1819-1001.dcm.png,patient is status post cabg . the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified granuloma is noted . 
3485,3660_IM-1820-1001.dcm.png,"lungs are clear without focal consolidation , effusion , or pneumothorax . normal heart size . bony thorax and soft tissue is unremarkable . "
3486,3661_IM-1821-1001.dcm.png,there are no focal areas of consolidation . no pleural effusions . no pneumothorax . heart size within normal limits . osseous structures intact . 
3487,3662_IM-1821-1001.dcm.png,"stable normal cardiomediastinal silhouette . bilateral calcified hilar/perihilar lymph xxxx . left lateral lung calcified granuloma . lungs are grossly clear without focal consolidation , pleural effusion , or pneumothorax . stable degenerative changes of the thoracic spine . no acute osseous abnormality . "
3488,3663_IM-1822-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3489,3664_IM-1822-1001.dcm.png,"there are no acute osseous abnormalities . soft tissue structures are within normal limits . normal heart size and hilar vascular markings . the lungs are clear without focal area of consolidation , pleural effusion , pneumothorax . "
3490,3665_IM-1823-1001.dcm.png,"heart size within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . no upper lobe airspace disease or cavitary lesions identified . "
3491,3666_IM-1824-1001.dcm.png,"onset right basal atelectasis with airspace disease and effusion suggestive of the chest infection . stable cardiomegaly and features of cabg . interval removal of left picc line , no pneumothorax . "
3492,3667_IM-1824-2001.dcm.png,density in the left upper lung on pa represents superimposed bony and vascular structures . there is calcification of the first rib costicartilage junction which contributes to this appearance . the lungs otherwise appear clear . the heart and pulmonary appear normal . in the pleural spaces are clear . the mediastinal contour is normal . there are degenerative changes of thoracic spine . there is an electronic cardiac device overlying the left chest wall with intact distal leads in the right heart . 
3493,3668_IM-1825-1001.dcm.png,unknown
3494,3669_IM-1826-1001.dcm.png,unknown
3495,3670_IM-1826-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there is mild biapical pleural thickening which is smooth . there is evidence of previous anterior cervical spine fusion . there are degenerative changes of the spine . "
3496,3671_IM-1827-3001.dcm.png,"stable cardiomediastinal silhouette . mild patchy right upper lobe opacities , similar to slightly improved from xxxx . left lung clear . no pleural effusion or pneumothorax . "
3497,3672_IM-1828-1001.dcm.png,stable appearance of aortic valve prosthesis . sternotomy xxxx . aortic calcifications . mild interstitial edema . no focal infiltrate . no effusion or pneumothorax . mild cardiomegaly . 
3498,3673_IM-1828-1001.dcm.png,the heart is normal in size . the mediastinal contours are stable . aortic calcifications are noted . there are small calcified lymph xxxx . emphysema and chronic changes are identified . there is opacity in the left perihilar upper lobe . there is questionable extension to the pleural surface . this may represent acute infiltrate or developing density . there is no pleural effusion or pneumothorax . 
3499,3674_IM-1829-0001-0001.dcm.png,unknown
3500,3675_IM-1829-0001-0001.dcm.png,and lateral chest examination was obtained . the heart silhouette and mediastinal contours are not enlarged . lungs demonstrate no acute findings . there is no effusion or pneumothorax . 
3501,3676_IM-1829-0001-0001.dcm.png,"the cardiomediastinal silhouette appears irregular secondary to the diffuse bilateral pulmonary interstitial disease . the thoracic aorta is tortuous . calcified lymph are demonstrated in the left hilum . no focal pulmonary consolidation . diffuse increased bilateral pulmonary interstitial markings , consistent with the patient's history of known pulmonary fibrosis , with relative sparing of the bilateral lung apices . no pneumothorax or pleural effusion demonstrated . the thoracic spine appears intact . "
3502,3677_IM-1830-2001.dcm.png,heart size is within normal limits . aorta is tortuous . remainder of the cardiomediastinal silhouette is normal . lungs are clear bilaterally without pleural effusion or pneumothorax . no bony abnormalities . 
3503,3678_IM-1831-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the costophrenic are blunted . the interstitial markings are slightly accentuated suggesting underlying chronic disease/emphysema . no focal consolidation is seen . 
3504,3679_IM-1831-1001.dcm.png,normal heart . clear lungs . no pneumothorax . no pleural effusion . 
3505,3680_IM-1832-1001.dcm.png,"the heart is normal in size and contour . there is no mediastinal widening . streaky bibasilar opacities , atelectasis . vague opacity in the right midlung . scattered calcified granulomas . no large pleural effusion or pneumothorax . the are intact . "
3506,3681_IM-1833-0001-0002.dcm.png,there are lower lung volumes . there is central bronchovascular crowding . volume loss in the medial right upper lobe seen on is not as well-demonstrated on radiography . no lobar consolidation . no pleural effusion or pneumothorax . 
3507,3682_IM-1834-1001.dcm.png,the lungs are hypoventilated . there is no focal airspace opacity . the cardiomediastinal silhouette is normal in size . there is no pneumothorax or large pleural effusion . 
3508,3683_IM-1835-3001.dcm.png,examination was performed with nipple markers . the previously noted small nodule in the right lower lung is not well-seen on today's study and may have been secondary to summation of structures . the heart is normal in size . the mediastinum is unremarkable . the lungs are otherwise clear . 
3509,3684_IM-1836-1001.dcm.png,unknown
3510,3685_IM-1836-1001.dcm.png,"calcified thoracic aorta . mild rightward deviation of the trachea , unchanged from comparison xxxx , secondary to a goiter . heart size within normal limits . no focal airspace disease . no pneumothorax or effusions . advanced degenerative change of the thoracic spine . "
3511,3686_IM-1837-0001-0001.dcm.png,unknown
3512,3687_IM-1838-2001.dcm.png,heart size and mediastinal contours are within normal limits given ap projection . the right lung appears clear . there is minimal patchy atelectasis or early infiltrate in left lung base . no visible pleural effusion or pneumothorax . there is a partially visualized ivc on the lateral view . there are partially visualized surgical changes the cervical spine compatible with prior fusion procedure . 
3513,3688_IM-1839-0001-0001.dcm.png,unknown
3514,3689_IM-1840-1001.dcm.png,normal heart size and mediastinal contours . calcified aortic xxxx . calcified granuloma in the anterior segment of the right lower lobe . no pleural effusion or pneumothorax . degenerative disc disease the thoracic spine . coronary artery stent . 
3515,3690_IM-1841-1001.dcm.png,the heart is again enlarged . aorta is tortuous . the lungs are hypoinflated but clear . no pleural effusion or pneumothorax is seen . 
3516,3691_IM-1842-1001.dcm.png,"the heart is normal in size . the mediastinum is stable . atherosclerotic calcifications of the aorta identified . there is no focal consolidation , pleural effusion or pneumothorax . degenerative changes of the thoracic spine are noted . "
3517,3692_IM-1843-1001.dcm.png,stable cardiomediastinal silhouette . pulmonary vascularity is within normal limits . lungs are expanded and clear airspace disease . negative for pneumothorax or pleural effusion . limited evaluation reveals the to be grossly intact . 
3518,3693_IM-1844-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . the previously seen right upper lobe mass lesion is not seen in study . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3519,3694_IM-1845-1001.dcm.png,"interval removal of left-sided chest tube . small residual left apical pneumothorax has increased slightly in size the prior exam , now measuring approximately 0 . 9 cm from the thoracic apex . stable cardiomediastinal silhouette . no focal airspace consolidation . no pleural effusion . "
3520,3695_IM-1845-1001.dcm.png,"the cardiac silhouette size is at the upper limits of normal . central vascular markings are mildly prominent . the lungs are normally inflated with no focal airspace disease , pleural effusion , or pneumothorax . no acute bony abnormality . "
3521,3696_IM-1846-1001.dcm.png,unknown
3522,3697_IM-1846-1001.dcm.png,"the cardiomediastinal silhouette is stable in appearance . there are extensive fibrotic changes in the right lung with rightward shift of the trachea , similar to the previous exam . the left lung is well-aerated without focal airspace consolidation , pleural effusions or pneumothorax . there is left apical pleural-parenchymal scarring . no acute bony findings . "
3523,3698_IM-1846-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3524,3699_IM-1846-1001.dcm.png,normal heart size mediastinal contours . no focal airspace consolidation . no pleural effusion or pneumothorax . degenerative disc disease in the thoracic spine with osteophyte formation bridging . 
3525,3700_IM-1848-1001.dcm.png,cardiomegaly is present . this is unchanged . there is mild prominence of the pulmonary vascularity which is unchanged . no focal airspace disease is seen . no pleural effusion or pneumothorax is identified . 
3526,3701_IM-1848-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3527,3702_IM-1849-22001.dcm.png,lungs are overall hyperexpanded with flattening of the diaphragms . lungs are clear without focal airspace disease . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes within the spine . there are expansile changes within the right clavicle which were seen on the previous xxxx/ct . findings are consistent with changes of multiple myeloma . 
3528,3703_IM-1850-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the posterior costophrenic are excluded on the lateral view . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
3529,3704_IM-1851-1001.dcm.png,"lungs are clear without focal consolidation , effusion or pneumothorax . normal heart size . bony thorax and soft tissues unremarkable"
3530,3705_IM-1851-1001-0001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . there has been a sternotomy . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
3531,3706_IM-1851-1001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is stable from prior exam . there is no pneumothorax or large pleural effusion . mediastinal surgical clips are again noted . "
3532,3707_IM-1851-1001.dcm.png,there may be a subtle airspace opacity in the right base near the midclavicular line . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
3533,3708_IM-1852-1001.dcm.png,"lung volumes are decreased from xxxx , and there is resultant bronchovascular crowding . no evidence of focal airspace disease . no definite pleural effusion or pneumothorax . cardiomediastinal silhouette is within normal limits given the low lung volumes . no free subdiaphragmatic air . grossly stable mild degenerative changes of the right lower thoracic spine . "
3534,3709_IM-1852-1001.dcm.png,"the mediastinal silhouette is widened with overlying sternotomy xxxx . the heart size is normal . the lungs are clear without evidence of effusion , infiltrate or pneumothorax . visualized bony structures are intact with no acute abnormalities . "
3535,3709_IM-1852-4001.dcm.png,"the mediastinal silhouette is widened with overlying sternotomy xxxx . the heart size is normal . the lungs are clear without evidence of effusion , infiltrate or pneumothorax . visualized bony structures are intact with no acute abnormalities . "
3536,3712_IM-1854-1001.dcm.png,changes of renal osteodystrophy are noted . heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . 
3537,3713_IM-1855-1001.dcm.png,unknown
3538,3714_IM-1856-1001.dcm.png,"cardio mediastinal silhouette , pulmonary vascular pattern are within normal limits . mildly low lung volumes . no focal infiltrate , pleural effusion or pulmonary edema . no pneumothorax . "
3539,3715_IM-1856-1001.dcm.png,unknown
3540,3716_IM-1856-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . bilateral nipple jewelry . "
3541,3716_IM-1856-3001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . negative for acute displaced rib fracture . bilateral nipple jewelry . "
3542,3717_IM-1856-1001.dcm.png,low lung volumes . normal heart size . no pneumothorax . no large effusion . no focal infiltrate . 
3543,3719_IM-1857-1001.dcm.png,unknown
3544,3720_IM-1859-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3545,3721_IM-1859-1001.dcm.png,streaky opacity is noted within the left lung base which may represent focal area of atelectasis . right lung is grossly clear . cardiac silhouette and mediastinal contours are within normal limits . there is no pneumothorax . no large pleural effusion . 
3546,3722_IM-1859-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . 
3547,3723_IM-1860-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
3548,3724_IM-1860-2001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3549,3725_IM-1861-1001.dcm.png,lungs are clear without focal infiltrates . calcified right upper lobe granuloma unchanged from prior . no pneumothorax or pleural effusion . normal heart size . normal pulmonary vascularity . bony thorax intact . 
3550,3726_IM-1862-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3551,3727_IM-1863-1001.dcm.png,lung volumes are low . no focal infiltrates . heart and pulmonary normal . an indwelling catheter from the left has its tip at the superior xxxx . 
3552,3728_IM-1864-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . the visualized osseous structures and upper abdomen are unremarkable . "
3553,3729_IM-1864-1001.dcm.png,chest . normal heart size . mediastinal silhouette is unremarkable . no focal infiltrates or masses . no pneumothorax or visible pleural fluid . no free intraperitoneal air in the diaphragm . osseous structures unremarkable . abdomen: there are no dilated loops of bowel to suggest obstruction . no air-fluid levels or free intraperitoneal air . no suspicious calcifications . there is curvature of the thoracolumbar spine . otherwise the osseous structures are grossly unremarkable . 
3554,3730_IM-1864-1001.dcm.png,unknown
3555,3731_IM-1865-1001.dcm.png,lungs are clear . heart and mediastinum appear normal . no pleural effusion or pneumothorax . 
3556,3732_IM-1866-1001.dcm.png,"calcified left hilar lymph node . lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
3557,3733_IM-1866-1001.dcm.png,heart size is enlarged . cardiomediastinal contours are unchanged since previous exam . there is blunting of the right costophrenic old pleural scar . lungs are otherwise clear bilaterally . a left upper lobe granuloma appears unchanged . there is kyphosis of the thoracic spine with anterior osteophyte formations . aortic ectasia is seen in the ascending aorta and the xxxx . 
3558,3734_IM-1866-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
3559,3735_IM-1866-1001.dcm.png,the cardiac contours are normal . atherosclerotic aorta . the lungs are clear . thoracic spondylosis . 
3560,3737_IM-1867-2001.dcm.png,heart size within normal limits . no focal airspace disease . no pneumothorax or pleural effusion . 
3561,3738_IM-1867-1001.dcm.png,"the heart size and mediastinal contours appear within normal limits . no focal airspace consolidation , pleural effusion or pneumothorax . no acute bony abnormalities . "
3562,3739_IM-1868-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . no focal airspace disease . left upper lobe granuloma . no evidence of active tuberculosis . stable chronic blunting of the right costophrenic xxxx . no pneumothorax . the are intact . 
3563,3740_IM-1868-1001.dcm.png,diffuse right lower lobe airspace opacity is present . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
3564,3741_IM-1869-1002001.dcm.png,the lungs are clear . no pleural effusion is seen . the heart and mediastinum are normal . the skeletal structures are normal . there are surgical clips in the right axilla region . 
3565,3742_IM-1869-1002001.dcm.png,cardiac and mediastinal contours are within normal limits . prior granulomatous disease . the lungs are clear . bony structures are intact . 
3566,3743_IM-1870-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3567,3744_IM-1871-0001-0001.dcm.png,unknown
3568,3745_IM-1872-1001.dcm.png,cardiomediastinal silhouette and pulmonary vasculature are within normal limits . lungs are clear . no pneumothorax or pleural effusion . no acute osseous findings . 
3569,3746_IM-1872-1001.dcm.png,"compared to prior examination , stent has been removed . cardiomediastinal silhouette is stable and within normal limits . stable mild atherosclerotic calcifications of the aortic are noted . there are mildly low lung volumes without focal consolidation , pneumothorax , or effusion identified . no acute bony abnormality seen . "
3570,3747_IM-1873-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3571,3748_IM-1874-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . there is minimal atelectasis or scar in the left lung base . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3572,3749_IM-1874-1001.dcm.png,lungs are clear bilaterally . cardiac and mediastinal silhouettes are normal . pulmonary vasculature is normal . no pneumothorax or pleural effusion . no acute bony abnormality . 
3573,3750_IM-1874-1001.dcm.png,there is stable cardiomegaly . right pleural effusion is slightly increased in size . pulmonary vasculature is persistently enlarged . prominent interstitium is stable . no focal infiltrate . no pneumothorax . visualized osseous structures intact . 
3574,3751_IM-1875-1001.dcm.png,the lungs are clear without evidence of focal airspace disease . there is no evidence of pneumothorax or large pleural effusion . the cardiac and mediastinal contours are within normal limits . the are unremarkable . 
3575,3752_IM-1876-6001.dcm.png,unknown
3576,3753_IM-1877-1001.dcm.png,"the cardiac silhouette , upper mediastinum and pulmonary vasculature are within normal limits . there is no acute pulmonary consolidation , large effusion or pneumothorax . there is minimal left basilar atelectasis . there are small bilateral pulmonary nodules measure approximately 5 mm in size in the right midlung and left upper lung xxxx . these are not well appreciated on the lateral projection . "
3577,3754_IM-1878-2001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are grossly clear . 
3578,3755_IM-1879-1001.dcm.png,heart size upper limits of normal . pulmonary vascular engorgement appears within limits of normal . no consolidating airspace disease is seen within the lungs . no pleural effusion or pneumothorax . bridging syndesmophytes are noted throughout visualized thoracolumbar spine . this could indicate diffuse idiopathic skeletal hyperostosis . this is similar to prior imaging . 
3579,3756_IM-1880-1001.dcm.png,"mediastinal contours are normal . unchanged opacity in the left lung base , scarring . lungs are clear . there is no pneumothorax or large pleural effusion . "
3580,3757_IM-1881-12012.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . mild tortuosity of the descending thoracic aorta . sternotomy noted . inferior sternotomy is disrupted . 
3581,3758_IM-1882-1001.dcm.png,unknown
3582,3759_IM-1883-1001.dcm.png,there is hyperexpansion of lungs and flattening of the diaphragm consistent with copd . no focal lung consolidation . no pneumothorax or pleural effusion . heart size and pulmonary vascularity are within normal limits . there is a kyphosis and osteopenia of the thoracic spine . no displaced rib fractures . 
3583,3760_IM-1883-1001.dcm.png,"sternotomy remain in xxxx . the cardiomediastinal silhouette is within normal limits for appearance . the thoracic aorta is tortuous . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . moderate degenerative changes of the thoracic spine . no acute , displaced rib fractures identified . "
3584,3761_IM-1883-1001.dcm.png,heart size is mildly enlarged . tortuous aorta . lungs are normally inflated and clear . mild degenerative changes of the spine . 
3585,3762_IM-1883-1001.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . calcified left coronary arteries noted . visualized osseous structures appear intact . "
3586,3763_IM-1883-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3587,3764_IM-1884-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3588,3765_IM-1884-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3589,3766_IM-1885-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are atherosclerotic changes of the aorta . there are severe arthritic changes of the with mild arthritic changes of the thoracic spine . 
3590,3767_IM-1886-2001.dcm.png,unknown
3591,3768_IM-1887-1001.dcm.png,mild cardiomegaly . changes of chronic lung disease . no pneumothorax or pleural effusion . accentuated thoracic kyphosis . 
3592,3769_IM-1888-4001.dcm.png,"the lung volumes are low . however as compared to the prior study , there are increased perihilar opacities bilaterally . stable dextroscoliosis of the lower thoracic spine with limited evaluation of the spinal xxxx . the tracheostomy tube is in unchanged position . "
3593,3770_IM-1890-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart and mediastinum of normal size and contour . degenerative changes in the spine . 
3594,3771_IM-1890-1001.dcm.png,unknown
3595,3772_IM-1891-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . calcified granuloma are present . degenerative changes are present in the spine . 
3596,3773_IM-1891-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size upper limits of normal , predominantly left ventricular contour ( xxxx visualized on lateral projection ) , pulmonary vascularity within normal limits . . "
3597,3774_IM-1892-1001.dcm.png,heart size is within normal limits . tortuous aorta . clear lungs . no pneumothorax . no pleural effusion . atherosclerotic calcification within the aorta . right lower lung granuloma . 
3598,3775_IM-1893-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
3599,3776_IM-1893-1001.dcm.png,unknown
3600,3777_IM-1894-1001.dcm.png,"low lung volumes . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is normal . mild degenerate change of the thoracic spine . stable cholecystectomy clips in the right upper quadrant . "
3601,3778_IM-1894-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3602,3779_IM-1894-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3603,3780_IM-1896-3003.dcm.png,unknown
3604,3781_IM-1897-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . cardiomediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . a right humeral intramedullary is noted incidentally , without evidence of complicating features . "
3605,3782_IM-1898-1001.dcm.png,unknown
3606,3783_IM-1898-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
3607,3784_IM-1898-2001.dcm.png,ap view was obtained due to patient condition . low volume lungs . no focal lung consolidation . the heart is not enlarged . no pleural effusion . 
3608,3785_IM-1898-2001.dcm.png,"no pneumothorax or large pleural effusion . mildly prominent perihilar opacities , due to bronchovascular crowding . heart size within normal limits . cardiomediastinal silhouette is xxxx . the bony structures appear intact . "
3609,3787_IM-1900-1001.dcm.png,"heart size is normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures appear intact . "
3610,3789_IM-1902-1001.dcm.png,"mild cardiomegaly is unchanged . stable superior mediastinal contour appear normal pulmonary vascularity . no airspace opacity , pleural effusion , or pneumothorax . no acute bony abnormalities . right upper quadrant surgical clips . "
3611,3790_IM-1904-0001-0002.dcm.png,low lung volumes . elevation of the right hemidiaphragm . patchy opacities right base again noted . left lung clear . heart size top normal . aortic calcification . granulomas . no evidence of pneumothorax . blunting of the bilateral costophrenic xxxx . degenerative changes of the thoracic spine . 
3612,3791_IM-1905-1001.dcm.png,unknown
3613,3792_IM-1906-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3614,3793_IM-1907-1001.dcm.png,no acute osseous abnormality . scattered degenerative changes throughout the thoracic spine . normal heart size . tortuous and dilated aorta . chronic interstitial markings . left base opacity . no pneumothorax or pleural effusion . 
3615,3794_IM-1908-1001.dcm.png,"heart size , aortic and mediastinal contours are within normal limits . the lungs are clear . no visible pneumothorax or large pleural effusion . 6 mm nodular opacity overlies the left anterior 5th rib on the frontal view . no focal bony abnormality identified . "
3616,3795_IM-1909-1001.dcm.png,"2 images . moderate thoracic dextroscoliosis , similar to prior imaging . heart size is normal . no focal airspace consolidation is seen within the lungs . no pleural effusion or pneumothorax . "
3617,3796_IM-1909-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pneumothorax . no pleural effusion . the thoracic spine appears intact . no acute , displaced rib fractures . "
3618,3797_IM-1910-0001-0002.dcm.png,and lateral chest examination was obtained . the heart silhouette and mediastinal contours are not enlarged . lungs demonstrate left lower lobe air space opacity with atelectasis without significant change . there is no effusion or pneumothorax . 
3619,3798_IM-1911-1001.dcm.png,the heart is normal in size . the pulmonary vascularity is within normal limits in appearance . no pneumothorax or pleural effusion . patchy right lower lung opacification is noted . 
3620,3799_IM-1911-4001.dcm.png,unknown
3621,3801_IM-1912-1001.dcm.png,"there are midline sternotomy and mediastinal clips consistent with prior cabg . the heart is enlarged with unfolding of the aorta . there is prominence of the interstitial markings with fluid in the fissures consistent with interstitial edema . there is no focal airspace opacity , large pleural effusion , or pneumothorax . there multilevel degenerative spine changes . "
3622,3802_IM-1912-1001-0002.dcm.png,"the cardiomediastinal silhouette is normal size and configuration . tortuous aorta with atherosclerotic calcification . pulmonary vasculature within normal limits . the lungs are well-aerated . there is no pneumothorax , pleural effusion , or focal consolidation . there are multiple overlying leads at the level of the left lower chest , with overlying or clothing there is this is thought to account for mild increased density the left lung base on ap view , with correlate on lateral view . degenerative spine . "
3623,3803_IM-1913-3001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . the aorta is tortuous and atherosclerotic . the lungs are hyperexpanded with flattening of hemidiaphragms and increased retrosternal airspace . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are degenerative changes in the thoracic spine . "
3624,3804_IM-1914-1001.dcm.png,"cardiomediastinal silhouette stable and within normal limits for size with unchanged atherosclerosis and tortuosity thoracic aorta . there is no focal consolidation , pneumothorax , or effusion . no acute bony abnormality . stable left proximal humeral enchondroma versus remote bony infarct . stable multilevel degenerative disc disease of the thoracic spine . calcified granuloma seen anteriorly on lateral view is stable since xxxx . "
3625,3805_IM-1915-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3626,3806_IM-1916-2001.dcm.png,the heart is normal in size . the mediastinum is grossly within normal limits . moderate thoracolumbar scoliosis and patient rotation somewhat limits evaluation of the mediastinum . the lungs are clear . 
3627,3807_IM-1917-1001.dcm.png,there are stable postoperative changes of left thoracotomy and left upper lobectomy . the lungs are clear . no focal airspace consolidation . no suspicious pulmonary mass or nodule is seen . there is no pleural effusion or pneumothorax . stable elevation of the left hemidiaphragm . normal heart size and mediastinal contour . 
3628,3808_IM-1918-1001.dcm.png,"heart size and mediastinal contour within normal limits . atherosclerotic calcification of the aorta . stable scattered calcified granulomas are noted . no focal airspace consolidation , pneumothorax , or large pleural effusion . no acute osseous abnormality . "
3629,3809_IM-1919-1002001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3630,3810_IM-1920-1001.dcm.png,"the heart and mediastinum are unremarkable . the lungs are clear without infiltrate . there is no effusion or pneumothorax . there is surgical clips projected over the left lung apex , as well as , over the right upper quadrant of the abdomen . "
3631,3811_IM-1921-1001.dcm.png,unknown
3632,3812_IM-1922-2001.dcm.png,"normal heart size and mediastinal contour . atherosclerotic calcification of the aortic xxxx . no abnormal airspace consolidation . no pleural effusion or pneumothorax . stable biapical lucency and apical scarring , consistent with emphysema . visualized osseous structures are unremarkable . "
3633,3813_IM-1922-1001.dcm.png,there is opacity left lung base may represent atelectasis or early infiltrate . the cardiomediastinal silhouette is within normal limits . no pneumothorax or pleural effusion . 
3634,3814_IM-1923-1001.dcm.png,"no focal consolidation , pneumothorax or definite pleural effusion . heart size within normal limits , no mediastinal widening characteristic in appearance of vascular injury . no acute osseous injury demonstrated . "
3635,3815_IM-1924-1001.dcm.png,unknown
3636,3816_IM-1925-1001.dcm.png,heart size is at the upper limits of normal . the pulmonary vascularity appears within normal limits . the lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . degenerative changes are present in the spine . no non-calcified nodules are identified . 
3637,3817_IM-1925-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
3638,3818_IM-1925-1001.dcm.png,"heart and mediastinum within normal limits . negative for focal pulmonary consolidation , pleural effusion , or pneumothorax . "
3639,3819_IM-1926-1001.dcm.png,frontal ( on two cassettes ) and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . the cardiac silhouette remains markedly enlarged . there is aortic vascular calcification . no focal airspace consolidation or pleural effusion . 
3640,3819_IM-1926-4004.dcm.png,frontal ( on two cassettes ) and lateral views of the chest with overlying external cardiac monitor leads show an unchanged cardiomediastinal silhouette . the cardiac silhouette remains markedly enlarged . there is aortic vascular calcification . no focal airspace consolidation or pleural effusion . 
3641,3820_IM-1928-1001.dcm.png,"the lungs and pleural spaces show no acute abnormality . heart size upper limits of normal , pulmonary vascularity within normal limits . straightening of the normal thoracic kyphosis . levocurvature the lumbar spine , incompletely imaged . "
3642,3821_IM-1929-1001.dcm.png,"the lungs are clear , and without focal air space opacity . cardiomediastinal silhouette is normal in size and contour , and stable . there is no pneumothorax or large pleural effusion . "
3643,3822_IM-1930-1001.dcm.png,unknown
3644,3823_IM-1930-1001.dcm.png,unknown
3645,3824_IM-1931-1001.dcm.png,unknown
3646,3825_IM-1931-1001.dcm.png,unknown
3647,3826_IM-1932-1001.dcm.png,"heart size and cardiomediastinal contours are normal . lungs are clear without focal air space opacity , pleural effusion , or pneumothorax . osseous structures are intact . "
3648,3827_IM-1932-1001.dcm.png,no focal lung consolidation . heart size and pulmonary vascularity are within normal limits . no pneumothorax or pleural effusion . osseous structures are grossly intact . 
3649,3828_IM-1932-1001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no large pleural effusion or pneumothorax . the are intact . 
3650,3829_IM-1932-1001.dcm.png,stable moderate cardiomegaly . mediastinal contours are unchanged . stable prominence of the central pulmonary vasculature with coarse central interstitial markings . decreased left basilar airspace disease . no visible pleural effusion or pneumothorax . 
3651,3830_IM-1933-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3652,3831_IM-1934-1001.dcm.png,clear lungs . no infiltrates or suspicious pulmonary opacity . no pleural effusion or pneumothorax . cardiomediastinal silhouette within normal limits . 
3653,3832_IM-1935-1002001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not enlarged . there are calcified mediastinal lymph xxxx . the skeletal structures are normal . 
3654,3833_IM-1936-1001.dcm.png,"no focal consolidation , pneumothorax , or large pleural effusion identified . stable blunting of the right costophrenic due to pleural thickening/sclerosis . redemonstration and stable appearance of bilateral calcified granulomas/lymph xxxx . changes in the lungs consistent with copd/emphysema . cardiomediastinal silhouette stable and unremarkable . no acute osseous abnormalities identified . opacity in the left apex consistent with radiation change seen on prior ct . "
3655,3834_IM-1937-1001.dcm.png,"there is an s-shaped scoliosis of the thoracic spine . heart size and pulmonary vascularity within normal limits . no focal infiltrate , pneumothorax or pleural effusion identified . "
3656,3835_IM-1938-3001.dcm.png,"lungs are clear bilaterally . there is no focal consolidation , pleural effusion , or pneumothoraces . there is widening adjacent to the right paratracheal stripe , most represents the svc with rotated position . are unremarkable . "
3657,3836_IM-1939-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . the lungs are free of any focal infiltrates . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
3658,3837_IM-1939-1001.dcm.png,lungs are clear . there is no pneumothorax or pleural effusion . the heart and mediastinum are within normal limits . bony structures are intact . 
3659,3840_IM-1941-2001.dcm.png,no acute osseous abnormality . degenerative changes throughout the thoracic spine . soft tissue structures are within normal limits . there is stable enlargement of the heart . stable prominent mediastinal contours . central vascular congestion . mildly low lung volumes bilaterally . bibasilar and left perihilar airspace opacities . bilateral pleural effusions . no pneumothorax . 
3660,3841_IM-1942-1001.dcm.png,"no acute osseous abnormalities . mild thoracic spine degenerative changes . soft tissues are within normal limits . no focal area of consolidation , pleural effusion , or pneumothorax . "
3661,3842_IM-1943-1001.dcm.png,unknown
3662,3843_IM-1944-1001.dcm.png,a right-sided chest remains in with the distal tip at the level of the mid svc . the cardiomediastinal silhouette is within normal limits for appearance . no focal areas of pulmonary consolidation . no pulmonary nodules or mass lesions identified . no pneumothorax or pleural effusion . mild degenerative changes of the thoracic spine . 
3663,3844_IM-1945-1001.dcm.png,lungs are clear . no pleural effusions or pneumothoraces . heart size is upper limits of normal . 
3664,3845_IM-1945-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3665,3846_IM-1946-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . the right lung is clear . there is a recurrence moderate-sized left pleural effusion . no pneumothorax . limited right base stringy density compatible with atelectasis . dextroscoliosis of the thoracic spine . 
3666,3847_IM-1946-1001.dcm.png,"both lungs remain hyperexpanded . no focal infiltrates . a small pleural or collection is present in the right apex . however , it has decreased considerably since the previous examination . heart size remains normal . "
3667,3848_IM-1946-1001-0001.dcm.png,the heart size is moderate to severely enlarged . there is prominence of the central pulmonary suggesting pulmonary artery hypertension . there has been removal of the right-sided picc line . there is persistent left basilar airspace opacity with left costophrenic blunting which is not evident on the lateral exam . there are mild degenerative changes of the spine . there is no pneumothorax . 
3668,3849_IM-1947-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . degenerative disease is seen in the thoracic spine and left xxxx . "
3669,3850_IM-1948-1001.dcm.png,unknown
3670,3851_IM-1948-1001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . nodular densities consistent with chronic granulomatous disease . bony structures appear intact . heart size normal . "
3671,3852_IM-1949-4004.dcm.png,heart size is normal . no pneumothorax or focal airspace disease . no pleural effusion . eventration of the right hemidiaphragm . mild degenerative changes of the thoracic spine without fracture . 
3672,3853_IM-1950-1001.dcm.png,unknown
3673,3854_IM-1950-1001.dcm.png,frontal and lateral views of the chest with overlying external cardiac monitor leads show normal size and configuration of the cardiac silhouette . normal pulmonary vasculature and central airways . no focal airspace consolidation or pleural effusion . 
3674,3855_IM-1950-1001.dcm.png,"in the interval , the interval , there has been development of multiple nodules in both the upper and lower lobes bilaterally . the previously identified left lower lobe nodule has increased in size . left hemidiaphragm is slightly elevated , possibly from splinting . the mediastinum remains normal . heart size normal . "
3675,3856_IM-1951-1001.dcm.png,"pa and lateral views . the cardiomediastinal silhouette is normal . the lungs are clear . no effusions , consolidation or pneumothorax . "
3676,3857_IM-1952-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3677,3858_IM-1953-4004.dcm.png,3 images . heart size is normal . there is mild tortuosity of the thoracic aorta . there are costochondral calcifications . the lungs are clear of focal infiltrate . no pleural effusion or pneumothorax . old left clavicle fracture noted . 
3678,3860_IM-1954-2001.dcm.png,the heart size and mediastinal silhouette are within normal limits for contour . the lungs are clear . no pneumothorax or pleural effusions . the are intact . 
3679,3861_IM-1955-1001.dcm.png,"no pneumothorax , pleural effusion , or focal airspace disease . heart size within normal limits . cardiomediastinal silhouette is clear . bony structures appear intact . "
3680,3862_IM-1956-2001.dcm.png,unknown
3681,3863_IM-1957-1001.dcm.png,"the lungs are clear , and without focal airspace opacity . the cardiomediastinal silhouette is enlarged . there is no pneumothorax or large pleural effusion . "
3682,3865_IM-1958-1001.dcm.png,"the heart is top normal in size . the mediastinum is stable . the lungs are grossly clear . bilateral rib deformities are noted , possibly old fractures . there is no pleural effusion or pneumothorax . "
3683,3866_IM-1959-0001-0001.dcm.png,patchy airspace disease is noted within the right middle lobe . subtle opacities are present within the lingula as well . there is no pneumothorax or pleural effusion . the heart size is normal . 
3684,3867_IM-1960-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are clear of focal airspace disease , pneumothorax , or pleural effusion . there are no acute bony findings . "
3685,3868_IM-1961-1001.dcm.png,unknown
3686,3869_IM-1962-1001.dcm.png,"there are changes of prior midline sternotomy with surgical clips consistent with cabg , and stable mild cardiomegaly . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . visualized osseous structures appear intact . "
3687,3870_IM-1963-4001.dcm.png,unknown
3688,3871_IM-1964-1001.dcm.png,unknown
3689,3872_IM-1964-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
3690,3873_IM-1965-1001.dcm.png,unknown
3691,3874_IM-1966-1001.dcm.png,"the heart and mediastinum are unremarkable . there is mild calcification of the aortic xxxx , consistent with atherosclerosis . the lung volumes are low , with bronchovascular crowding . the lungs are clear without infiltrate . there is no effusion or pneumothorax . moderate degenerative changes of the spine . "
3692,3875_IM-1967-1001.dcm.png,stable left lower lung increased interstitial markings . no focal alveolar opacities . low lung volumes . heart size is normal . no pneumothorax or pleural effusions . 
3693,3876_IM-1967-1001.dcm.png,"the heart is normal size . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . there is stable mild deformity of the lower thoracic vertebral body . "
3694,3877_IM-1967-1001.dcm.png,"compared to prior chest radiograph from xxxx , there has been removal of right-sided tunneled dialysis catheter . the cardiomediastinal silhouette is stable and within normal limits for size and contour . mildly increased atherosclerotic calcifications of the thoracic aorta . 1 . 0 cm nodular opacity in the left midlung is stable compared to prior examination from xxxx . no nodules , focal consolidation , or pneumothorax identified . there are bilateral pleural effusions posteriorly . there is mild central pulmonary vascular congestion without pulmonary edema . no acute bony abnormality . "
3695,3878_IM-1968-1001.dcm.png,postop changes of cabg with mild cardiomegaly . there is an infiltrate in the right lower lobe . thoracic spondylosis . 
3696,3879_IM-1968-1001.dcm.png,the lungs and pleural spaces show no acute abnormality . heart size and pulmonary vascularity within normal limits . 
3697,3880_IM-1968-1001.dcm.png,unchanged cardiomegaly . negative for pneumothorax or focal consolidation . no large effusion . mildly prominent interstitial opacities . 
3698,3881_IM-1969-1001.dcm.png,the heart size and pulmonary vascularity appear within normal limits . right hemidiaphragm remains elevated . no pleural effusion is seen . no pneumothorax is identified . no discrete nodules or adenopathy are noted . degenerative changes are present in the spine . right xxxx-a-xxxx has been inserted since the previous study . the tip projects over the lower superior xxxx . 
3699,3882_IM-1970-1001.dcm.png,eventration of the left diaphragm is noted . question left basilar atelectasis versus infiltrate . no evidence of pneumothorax . generalized lung volumes . no definite pleural effusions . heart size within normal limits . osseous structures intact . 
3700,3883_IM-1971-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . are intact . "
3701,3884_IM-1971-1001.dcm.png,"diffuse , right greater than left , interstitial opacities . central vascular congestion . no pneumothorax or focal consolidation . no pleural effusion . heart size normal . "
3702,3885_IM-1971-1001.dcm.png,"the heart , pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . "
3703,3886_IM-1971-1001.dcm.png,unknown
3704,3887_IM-1972-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal suggests possible right versus dextrocardia . visualized osseous structures of the thorax are without acute abnormality . "
3705,3888_IM-1972-2001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3706,3889_IM-1973-1001.dcm.png,"heart size is normal . no pneumothorax , pleural effusion , or focal airspace disease . bony structures appear intact . "
3707,3890_IM-1973-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
3708,3891_IM-1973-1001.dcm.png,unknown
3709,3892_IM-1974-0001-0001.dcm.png,"normal heart size . bibasilar patchy opacities , left greater than right . no pneumothorax or large pleural effusions . left-sided subclavian central venous catheter with tip in the right atrium . no significant pulmonary edema . low lung volumes . exaggeration of the thoracic kyphosis with evidence of lower thoracic vertebral body the deep opacities . multiple mild vertebral body wedge deformities in the mid thoracic spine . moderate degenerative changes of the thoracic spine . multiple bilateral rib fractures , some of which appear old . interval deformity of the vertebral body the level of the two vertebroplasty xxxx . "
3710,3893_IM-1975-3001.dcm.png,"there are mildly diminished lung volumes . cardiac silhouette is normal in size . normal mediastinal contour and pulmonary vasculature . the lungs are without focal airspace consolidation , large pleural effusion , or pneumothoraces . "
3711,3894_IM-1976-1001.dcm.png,unknown
3712,3895_IM-1977-1001.dcm.png,there are scattered opacities in the left lower lobe . cardiac silhouette is within normal limits . there is prominence of the right and left hilum representing enlargement of the central pulmonary arteries . no pneumothorax or pleural effusion . no acute bone abnormality . 
3713,3897_IM-1978-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3714,3898_IM-1978-1001.dcm.png,"the cardiomediastinal silhouette is normal in size and contour . no focal consolidation , pneumothorax or large pleural effusion . normal xxxx . "
3715,3899_IM-1978-1001.dcm.png,chest . mildly hyperexpanded lungs . the right lung base is excluded from view . no visualized consolidation . no pneumothorax . no large pleural effusions . heart size is unremarkable . abdomen . there are multiple air filled nondilated loops of small and large bowel . there is extensive stool seen throughout the descending colon . supine examinations are limited for evaluation of pneumoperitoneum . there is bilateral hip degenerative change . 
3716,3900_IM-1980-1001.dcm.png,unknown
3717,3901_IM-1980-1001.dcm.png,the heart is normal in size . the mediastinum is stable . postsurgical changes of esophagectomy and gastric pull-through are stable . bibasilar air space opacities have significantly improved . the lungs remain hypoinflated with blunted costophrenic xxxx . there is no pneumothorax . 
3718,3902_IM-1981-1001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3719,3903_IM-1982-1001.dcm.png,the heart is is at the upper limits of normal in size . the pulmonary vascularity is within normal limits in appearance . no focal air space opacities . no pleural effusions or pneumothorax . no acute bony abnormalities . 
3720,3904_IM-1983-1001.dcm.png,"cardiomediastinal silhouettes are within normal limits . lungs are clear without focal consolidation , pneumothorax , or pleural effusion . bony thorax is unremarkable . "
3721,3905_IM-1984-1001.dcm.png,"the heart is enlarged , stable compared to the previous exam . the mediastinum is unremarkable . there is no pleural effusion , pneumothorax , or focal airspace disease . the are unremarkable . "
3722,3907_IM-1985-1001.dcm.png,"there is stable , mild enlargement of the cardiac silhouette . stable mediastinal silhouette . there are low lung volumes with bronchovascular crowding . scattered opacities in the right lung base representing foci of subsegmental atelectasis with scattered airspace opacities in the medial left lower lobe . no pneumothorax . no pleural effusion . degenerative changes of the thoracic spine possibly consistent with dish . "
3723,3908_IM-1985-1001.dcm.png,"the examination consists of frontal and lateral radiographs of the chest . the cardiomediastinal contours are within normal limits . pulmonary vascularity is within normal limits . no focal consolidation , pleural effusion , or pneumothorax identified . multilevel thoracic spondylosis is again demonstrated . . "
3724,3909_IM-1986-1001.dcm.png,cardiac and mediastinal contours are within normal limits . right chest tip in the low svc . right granulomatous disease . the lungs are clear . bony structures are intact . 
3725,3910_IM-1987-1001.dcm.png,"heart size and cardiomediastinal contours are normal . low lung volumes without focal airspace opacity , pleural effusion , or pneumothorax . multilevel degenerative changes in the spine . "
3726,3911_IM-1987-1001.dcm.png,unknown
3727,3912_IM-1988-2001-0001.dcm.png,"examination is somewhat limited , the costophrenic and posterior costophrenic sulci are excluded . patient is rotated to the right . heart size upper limits normal , but stable . mediastinal contour is grossly unremarkable . lung parenchyma is clear , no focal airspace consolidation . no large effusion , no visible pneumothorax within the limits of the study . "
3728,3912_IM-1988-2001-0002.dcm.png,"examination is somewhat limited , the costophrenic and posterior costophrenic sulci are excluded . patient is rotated to the right . heart size upper limits normal , but stable . mediastinal contour is grossly unremarkable . lung parenchyma is clear , no focal airspace consolidation . no large effusion , no visible pneumothorax within the limits of the study . "
3729,3913_IM-1989-84584001.dcm.png,unknown
3730,3915_IM-1990-1001.dcm.png,"there is a in the left chest with catheter tip terminating in the superior xxxx . the cardiac silhouette is mildly enlarged , similar to prior study . there is minimal pulmonary vascular congestion . there is no acute pulmonary consolidation , pleural effusion or pneumothorax . there are stable mild interstitial lung changes , which could be related to chronic edema or fibrosis . "
3731,3916_IM-1991-1001.dcm.png,"heart size normal . lungs clear . normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3732,3917_IM-1992-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . mild cardiomegaly without acute cardiac abnormality . visualized osseous structures of the thorax are without acute abnormality . "
3733,3918_IM-1992-1001.dcm.png,"hyperinflated lungs with mildly flattened posterior diaphragm and increased retrosternal airspace . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . heart size within normal limits . no pneumothorax . "
3734,3919_IM-1992-1001.dcm.png,unknown
3735,3921_IM-1995-2001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . left-sided picc line has been placed in the interval with tip in the innominate vein . "
3736,3922_IM-1996-0001-0002.dcm.png,"stable cardiomediastinal silhouette . no focal pulmonary opacity , pleural effusion or pneumothorax . no acute bony abnormality . "
3737,3923_IM-1997-2002.dcm.png,unknown
3738,3925_IM-1999-1002001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are calcified right hilar and mediastinal lymph xxxx . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
3739,3925_IM-1999-1003002.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart is not significantly enlarged . there are calcified right hilar and mediastinal lymph xxxx . there are atherosclerotic changes of the aorta . arthritic changes of the skeletal structures are noted . 
3740,3926_IM-2000-4004.dcm.png,"the trachea is midline . the heart is large , unchanged from prior exam . slightly widened mediastinum , secondary to cardiomegaly and a tortuous aorta , is accentuated by ap portable technique . there are low lung volumes causing bibasilar atelectasis and bronchovascular crowding . the lungs do not demonstrate focal infiltrate or effusion . there is no pneumothorax . the visualized bony structures reveal no acute abnormalities . "
3741,3927_IM-2000-1001.dcm.png,unknown
3742,3928_IM-2000-1001.dcm.png,the cardiac contours are normal . aortic calcification . prior granulomatous disease . the lungs are clear . thoracic spondylosis . 
3743,3930_IM-2003-1001.dcm.png,lungs are overall hyperexpanded consistent with obstructive lung disease . lungs are clear without focal consolidation . no suspicious pulmonary nodules or masses are noted . no pleural effusions or pneumothoraces . heart size is upper limits of normal . 
3744,3931_IM-2003-3001.dcm.png,"the heart size is normal . the cardiomediastinal silhouette is stable in appearance . the lungs are clear without focal airspace opacity , pneumothorax , or pleural effusion . the are normal in appearance . "
3745,3932_IM-2004-1002.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . there is no definite focal infiltrate . there is no large pleural effusion . there is no pneumothorax . 
3746,3932_IM-2004-1003.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . there is no definite focal infiltrate . there is no large pleural effusion . there is no pneumothorax . 
3747,3932_IM-2004-1005.dcm.png,the cardiac silhouette mediastinal contours are within normal limits . there is no definite focal infiltrate . there is no large pleural effusion . there is no pneumothorax . 
3748,3933_IM-2004-1001.dcm.png,the heart size is normal . no pneumothorax . no large pleural effusions . no focal airspace opacities . 
3749,3934_IM-2005-0001.dcm.png,unknown
3750,3935_IM-2006-1001.dcm.png,left picc line remains in xxxx . the tip projects over the upper svc . it has moved outward since the previous study . the heart size and pulmonary vascularity appear within normal limits . previously present left base airspace disease has cleared . there is blunting of the right costophrenic which may represent small amount of pleural effusion or pleural reaction . some scattered bandlike opacities are present which appear to represent scars . degenerative changes are present in the right shoulder . 
3751,3936_IM-2007-1001.dcm.png,"heart size within normal limits . no alveolar consolidation , no findings of pleural effusion or pulmonary edema . no pneumothorax . "
3752,3937_IM-2008-1001.dcm.png,the heart size is upper limits of normal . the pulmonary and mediastinum are within normal limits . there is no pleural effusion or pneumothorax . there is no focal air space opacity to suggest a pneumonia . there are minimal degenerative changes of the spine . 
3753,3938_IM-2009-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3754,3939_IM-2010-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . osseous structures are within normal limits for patient age . . "
3755,3940_IM-2011-1001.dcm.png,"there is a stable closure device projected over the heart . the heart and mediastinum are otherwise normal . there is stable scarring of left mid lung . the lungs are otherwise clear . there is no infiltrate , effusion , mass or pneumothorax . "
3756,3941_IM-2012-0001-0002.dcm.png,cardiomegaly . no focal consolidation . no pleural effusions . no evidence of pneumothorax . osseous structures intact . levocurvature of the thoracic spine . lumbar vertebral body stabilization xxxx . 
3757,3942_IM-2013-1001.dcm.png,cardiac silhouette is at the upper limits of normal . lungs are clear bilaterally . there is no pleural effusion or pneumothorax . interval worsening of the moderate thoracolumbar dextroscoliosis with mild exaggeration of normal thoracic kyphosis . 
3758,3943_IM-2013-1001.dcm.png,the bony thorax is intact and the heart size is normal . the lung are free of infiltrate and there is no pleural effusion . we again note the left hilar calcifications that are unchanged from the prior studies . 
3759,3944_IM-2014-1001.dcm.png,mediport catheter seen on the right with the tip in the mid svc . the lungs appear to be clear . no pleural effusion is seen . the heart and mediastinum are normal . the skeletal structures are normal . 
3760,3945_IM-2014-1001.dcm.png,"there is increased size of left pneumothorax , with partial collapse of the left upper and lower lobes . this pneumothorax measures up to 3 . 5 cm in maximum width at the apex . there is no significant mediastinal shift . the right lung remains clear . cardiomediastinal silhouette is within normal limits . there is a small left pleural effusion/hemothorax . no focal air space opacities . no free subdiaphragmatic air . "
3761,3946_IM-2015-1001.dcm.png,there are no focal areas of consolidation . no suspicious pulmonary opacities . heart size within normal limits . no pleural effusions . there is no evidence of pneumothorax . osseous structures are intact . 
3762,3947_IM-2016-1001.dcm.png,"the lungs appear clear . there are no suspicious pulmonary nodules or infiltrates . the heart and pulmonary appear normal . the pleural spaces are clear . mediastinal contours are normal . there is a left-sided tunneled catheter , the distal tip at the mid superior level . "
3763,3948_IM-2017-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . no acute bone abnormality . "
3764,3949_IM-2018-4004.dcm.png,"apical lordotic frontal view . considering differences in technical factors stable cardiomediastinal silhouette with mild cardiomegaly . no focal alveolar consolidation , no definite pleural effusion seen . dense left lower lung nodule suggests a previous granulomatous process . no typical findings of pulmonary edema . "
3765,3951_IM-2019-1001.dcm.png,the cardiomediastinal silhouette is normal in size and contour . masslike opacification of right apex . no pneumothorax or large pleural effusion . are grossly normal . 
3766,3952_IM-2020-1001.dcm.png,"unchanged elevation of the right hemidiaphragm . the trachea is midline . negative for pneumothorax , pleural effusion or focal airspace consolidation . the heart size is mildly enlarged . mild degenerative changes throughout the thoracic spine anterior osteophytes noted inferiorly . pulmonary artery prominence . "
3767,3953_IM-2021-1001.dcm.png,"the lungs are clear bilaterally . specifically , no evidence of focal consolidation , pneumothorax , or pleural effusion . . cardio mediastinal silhouette is unremarkable . visualized osseous structures of the thorax are without acute abnormality . "
3768,3954_IM-2021-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are clear . 
3769,3955_IM-2021-1001.dcm.png,unknown
3770,3955_IM-2021-1003.dcm.png,unknown
3771,3956_IM-2021-1001.dcm.png,ap and lateral views of the chest were obtained . the heart is normal size . mediastinum is unremarkable . lungs are hypoinflated but clear . no focal consolidation is seen . 
3772,3957_IM-2022-1001.dcm.png,cardiac and mediastinal contours are within normal limits . the lungs are clear . bony structures are intact . 
3773,3958_IM-2022-1001.dcm.png,both lungs are clear and expanded . heart and mediastinum normal . 
3774,3959_IM-2023-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . sternotomy overlie the heart . 
3775,3960_IM-2025-1002.dcm.png,"heart size , mediastinal contour , and pulmonary vascularity are within normal limits . no focal consolidation , suspicious pulmonary opacity , large pleural effusion , or pneumothorax is identified . spondylosis of the midthoracic spine with large anterior osteophyte formations . "
3776,3961_IM-2026-1001.dcm.png,the heart size is normal . the mediastinal contour is within normal limits . there is a streaky opacity within the right upper lobe . there are no nodules or masses . no visible pneumothorax . no visible pleural fluid . the are grossly normal . there is no visible free intraperitoneal air under the diaphragm . 
3777,3962_IM-2027-1001.dcm.png,"heart size normal . lungs are clear . are normal . no pneumonia , effusions , edema , pneumothorax , adenopathy , nodules or masses . "
3778,3964_IM-2028-1001.dcm.png,the heart is normal in size . the mediastinum is unremarkable . the lungs are hyperinflated compatible with emphysema . there is biapical scarring . no acute infiltrate is seen . 
3779,3965_IM-2028-1001-0001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3780,3965_IM-2028-1001-0002.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3781,3965_IM-2028-3001.dcm.png,the heart and lungs have in the interval . both lungs are clear and expanded . heart and mediastinum normal . 
3782,3966_IM-2028-1001.dcm.png,"chest: the heart is normal size with normal appearance of the cardia mediastinal silhouette . there is no focal airspace opacity , pleural effusion , or pneumothorax . there are mild degenerative changes and thoracic spine . right knee: there are severe tricompartmental degenerative changes with obliteration of the joint spaces . there is no fracture or dislocation . left knee: there is joint space loss most prominent in the medial compartment . the of lateral view and limits evaluation for an effusion or the patellofemoral joint space . there is no fracture or dislocation . "
3783,3967_IM-2028-1001.dcm.png,"the cardiomediastinal silhouette is within normal limits for size and contour . the lungs are normally inflated without evidence of focal airspace disease , pleural effusion , or pneumothorax . mild degenerative endplate changes of the spine . "
3784,3968_IM-2029-1001.dcm.png,unknown
3785,3968_IM-2029-3001.dcm.png,unknown
3786,3969_IM-2030-1001.dcm.png,the lungs hyperexpanded suggesting emphysema . the heart size and pulmonary vascularity appear within normal limits . lungs are free of focal airspace disease . no pleural effusion or pneumothorax is seen . osteopenia and degenerative changes are present in the spine . 
3787,3970_IM-2031-1001.dcm.png,"lungs are clear bilaterally with no focal infiltrate , pleural effusion , or pneumothoraces . cardiomediastinal silhouette is within normal limits . and soft tissues are unremarkable . "
3788,3971_IM-2031-1001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion or pneumothorax . the bony structures are normal . "
3789,3971_IM-2031-3001.dcm.png,"the heart size and cardiomediastinal silhouette are normal . there is no focal airspace opacity , pleural effusion or pneumothorax . the bony structures are normal . "
3790,3972_IM-2032-1001.dcm.png,heart size and pulmonary vascularity appear within normal limits . bilateral hilar fullness is present consistent with adenopathy . the appearance is unchanged . there is prominence of the interstitial markings bilaterally . these are also unchanged . no focal superimposed airspace disease is seen . no pneumothorax or pleural effusion is noted . 
3791,3973_IM-2033-1001.dcm.png,unknown
3792,3974_IM-2034-2002.dcm.png,the lungs are hyperexpanded consistent with emphysema . the heart size and pulmonary vascularity appear within normal limits . no pneumothorax or pleural effusion is seen . patchy airspace disease is present in the right middle lobe . degenerative changes are present spine . 
3793,3975_IM-2035-1001.dcm.png,no focal consolidation . no visualized pneumothorax . no large pleural effusions . heart size normal . cardiomediastinal silhouette is unremarkable . 
3794,3976_IM-2035-1001.dcm.png,heart size and mediastinal contour are normal . pulmonary vascularity is normal . lungs are clear . no pleural effusions or pneumothoraces . 
3795,3977_IM-2036-1001.dcm.png,normal heart size . stable unfolding the thoracic aorta . no focal air space consolidation . no pleural effusion or pneumothorax . stable calcified granuloma in the left lower lobe . visualized osseous structures are unremarkable appearance . 
3796,3978_IM-2037-0001-0001.dcm.png,the heart is normal in size and contour . there is no mediastinal widening . the lungs are clear bilaterally . no pleural effusion or pneumothorax . are intact . 
3797,3979_IM-2038-1001.dcm.png,normal heart size . mild unfolding and atherosclerotic calcification of the aorta . no focal air space consolidation . no pneumothorax or pleural effusion . visualized bony structures are unremarkable in appearance . 
3798,3980_IM-2039-1001.dcm.png,"heart size moderately enlarged . mild left costophrenic blunting . streaky and patchy bibasilar opacities , left greater than right . right hemidiaphragm eventration noted . no typical findings of pulmonary edema . "
3799,3981_IM-2039-1001.dcm.png,the lungs are clear . there is no pleural effusion or pneumothorax . the heart and mediastinum are normal . the skeletal structures are normal . 
3800,3982_IM-2039-1001.dcm.png,"normal heart size . no focal airspace consolidation , pneumothorax , pleural effusion , or pulmonary edema . no focal bony abnormality . "
3801,3983_IM-2039-1001.dcm.png,there is a left basilar airspace opacity . right basilar atelectasis . the heart size and mediastinal silhouette are within normal limits for contour . no pneumothorax or pleural effusions . the are intact . 
3802,3984_IM-2040-1001.dcm.png,the lungs appear clear . the thoracic aorta remains tortuous . the presence of an aortic aneurysm cannot be excluded on this study xxxx . a there are calcified mediastinal and hilar lymph suggesting prior histoplasmosis infection . the pleural spaces are clear . 
3803,3985_IM-2041-1001.dcm.png,"no pneumothorax , pleural effusion or airspace consolidation . heart size and pulmonary vasculature appear within normal limits . calcified granuloma in the anterior left lower lobe . are intact . "
3804,3986_IM-2041-1001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
3805,3986_IM-2041-3001.dcm.png,the cardiomediastinal silhouette and vasculature are within normal limits for size and contour . the lungs are normally inflated and clear . osseous structures are within normal limits for patient age . 
3806,3987_IM-2041-1001.dcm.png,"no acute osseous abnormality . stable scattered endplate degenerative changes and osteophyte formation in the thoracic spine . normal cardiomediastinal silhouette and hilar contours . no focal area of consolidation , pleural effusion , or pneumothorax . "
3807,3988_IM-2041-1001.dcm.png,"no acute osseous abnormalities . left midlung , and basilar streaky opacity . there is elevation of the left hemidiaphragm . no pneumothorax . small calcified 8 cm granuloma adjacent to the right diaphragm within the right chest . cardiomediastinal silhouette is within normal limits . "
3808,3989_IM-2042-1001.dcm.png,"heart size within normal limits . right hemidiaphragm eventration noted . no focal alveolar consolidation , no definite pleural effusion seen . no typical findings of pulmonary edema . "
3809,3991_IM-2044-1001.dcm.png,the cardiac contours are normal . the lungs are clear . thoracic spondylosis . 
3810,3992_IM-2044-1001.dcm.png,unknown
3811,3993_IM-2044-1001.dcm.png,the heart is mildly enlarged . left hemidiaphragm is elevated . there is no acute infiltrate or pleural effusion . the mediastinum is unremarkable . 
3812,3994_IM-2045-2001.dcm.png,similar mild cardiomegaly . of the pulmonary vascularity is prominent . no focal consolidations or effusions . no pneumothorax . no acute bony abnormality . 
3813,3995_IM-2046-1001.dcm.png,"the cardiomediastinal silhouette and pulmonary vasculature are within normal limits in size . the lungs are mildly hyperinflated with flattening of the diaphragms and expansion of the retrosternal clear space . compared with prior exam , there has been interval resolution of previously demonstrated bibasilar infiltrates . there is minimal scarring or atelectasis in the right midlung . there is no focal airspace disease . there is no pneumothorax or pleural effusion . there are no acute bony findings . "
3814,3996_IM-2047-1001.dcm.png,the lungs are clear . heart size is normal . no pneumothorax . there are endplate changes in the spine . 
3815,3997_IM-2048-1001.dcm.png,"heart size within normal limits . small , nodular opacity in the right upper lobe . this does not look like an acute infiltrate , and more represents a granuloma . no pneumothorax or effusions . "
3816,3998_IM-2048-1001.dcm.png,unknown
3817,3999_IM-2049-1001.dcm.png,unknown