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paired_output/audio_03841.txt

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+Suggested further evaluation with contrast study/PET scan followed by histopathology.
+Investigations have their limitations. Solitary pathological/Radiological and other investigations never confirm the final diagnosis. They only help in diagnosing the disease in correlation to clinical symptoms and other related tests. Please interpret accordingly.

paired_output/audio_03842.txt

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+T2/FLAIR hyperintensity in the right temporal lobe likely represents post-treatment changes.
+Encephalomalacia with gliotic changes in the left parietal region (postcentral gyrus).
+Chronic lacunar infarct in the right thalamocapsular region.

paired_output/audio_03843.txt

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+Impression:
+Multiple conglomerate and discrete ring-enhancing lesions in the right fronto-temporal region with surrounding oedema, GRE blooming, and minimal diffusion restriction, consistent with known tuberculomas.

paired_output/audio_03844.txt

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+No evidence of leptomeningeal disease.
+Comparison:
+Compared to the previous MRI study, the lesions in the right fronto-temporal region show interval evolution with persistent ring enhancement and surrounding oedema. No definite new lesions are identified.
+KEYIMAGES

paired_output/audio_03845.txt

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+showing conglomeration. These lesions appear hypointense on T1-weighted images and demonstrate T2/FLAIR hyperintensity with surrounding vasogenic oedema. On post-contrast sequences, there is peripheral rim enhancement. GRE blooming is noted within the lesions, suggestive of calcific or hemorrhagic components. Minimal diffusion restriction is seen within few lesions.

paired_output/audio_03846.txt

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+Encephalomalacia with gliotic changes is noted in the left parietal region in the region of the postcentral gyrus.
+A chronic lacunar infarct is noted in the right thalamocapsular region.
+No evidence of leptomeningeal or pachymeningeal enhancement is seen. No abnormal enhancement is noted in the basal cisterns.

paired_output/audio_03847.txt

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+There is associated surrounding perilesional oedema causing mild local mass effect without significant midline shift.
+T2/FLAIR hyperintense signal changes are noted in the right temporal lobe without significant post-contrast enhancement, likely representing post-treatment gliotic or inflammatory changes.

paired_output/audio_03848.txt

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+The ventricular system appears normal in size and configuration. No evidence of hydrocephalus.
+The brainstem appears normal. The cerebellum and other infratentorial structures appear unremarkable.
+No extra-axial collection is seen. Calvarium appears unremarkable.

paired_output/audio_03849.txt

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+MRI BRAIN WITH CONTRAST
+Clinical History:
+Known case of tuberculoma on follow-up.
+Findings:
+Multiple ring-enhancing lesions are noted in the right fronto-temporal region, with the largest lesion in the right frontal lobe measuring approximately 1.1 × 1.0 × 1.2 cm,

paired_output/audio_03850.txt

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+Acute infarct in right middle cerebral artery territory involving right ganglio-capsular region, right parietotemporal cortical bar subcortical region, right centrum semiovale and right corona radiata shows temporal evolution .
+Few hypointensities are seen within right ganglio-capsular region on GRE images, suggesting hemorrhagic transformation of infarct.

paired_output/audio_03851.txt

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+The intracranial vessels display normal flow void.
+The paranasal sinuses, orbits and calvarium appear unremarkable.
+Impressions -
+MR scan reveals:
+Temporal evoluation of acute infarct seen in right MCA territory with hemorrhagic transformation.

paired_output/audio_03852.txt

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+Midline shift of about 3.8 mm toward left.
+Mild chronic periventricular ischemic changes.
+Mild cerebral atrophy.

paired_output/audio_03853.txt

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+Mass effect is seen in the form of compression of right lateral ventricle. Midline shift of about 3.8 mm toward left is noted.
+No evidence of fresh infarct seen.
+Mild chronic periventricular ischemic changes are seen.
+Mild prominence of cerebral sulci, cisterns and ventricles is seen, suggestive of mild cerebral atrophy

paired_output/audio_03854.txt

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+Supraspinatus tendinosis with low-grade partial thickness tear involving less than 25% fibres noted in articular surface of supraspinatus footprint.
+High-grade partial thickness tear involving ~ 50% fibres noted in humeral attachment site of superior and mid fibres of subscapularis tendon.

paired_output/audio_03855.txt

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+The bones show normal signal intensity.
+No significant fat infiltration noted in rotator cuff muscles - Goutallier classification stage 0.
+IMPRESSION
+Supraspinatus tendinosis with low-grade partial thickness tear involving less than 25% fibres noted in articular surface of supraspinatus footprint.

paired_output/audio_03856.txt

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+High-grade partial thickness tear involving ~ 50% fibres noted in humeral attachment site of superior and mid fibres of subscapularis tendon.
+Mild acromio-clavicular joint arthrosis.
+Fraying of superior free margin of glenoid labrum – SLAP 1 tear.
+Minimal joint effusion.

paired_output/audio_03857.txt

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+Mild acromio-clavicular joint arthrosis.
+Fraying of superior free margin of glenoid labrum – SLAP 1 tear.
+Minimal joint effusion.
+The glenohumeral joint appears normal.
+The glenoid labrum appears normal. No evidence of labral tear.
+The middle and inferior glenohumeral ligaments appears normal

paired_output/audio_03858.txt

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+The long head of biceps and its attachment appears normal
+The supraspinatus and subscapularis tendons appear normal.
+The infraspinatus tendon, and teres minor tendon appear normal.
+The acromio clavicular joint appears normal.
+The coraco humeral ligament appears normal.

paired_output/audio_03859.txt

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+X-RAY CHEST
+VIEWS: PA View of Chest
+FINDINGS
+Lungs
+Bilateral lungs fields are clear.
+Airways
+Trachea is central. Tracheo-bronchial tree is normal.
+Heart
+Cardiac silhouette is normal.

paired_output/audio_03860.txt

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+Others
+Bilateral CP angles are clear.
+Both domes of diaphragm are normally placed.
+Bony thoracic cage is normal.
+No soft tissue abnormality seen.
+IMPRESSION
+No Abnormality Detected
+Suggested clinical correlation.

paired_output/audio_03861.txt

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+Mild anterior wedge compression deformity of the C5 vertebral body is noted.
+Subtle STIR hyperintensity is seen within the odontoid process of C2, suggestive of focal marrow edema.

paired_output/audio_03862.txt

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+Disc Spaces:
+C2-C3: There is no evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.

paired_output/audio_03863.txt

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+At the C6–C7 level, a posterior disc osteophyte complex causes mild indentation of the thecal sac without significant neural foraminal compromise or nerve root impingement.
+No osseous destruction noted.

paired_output/audio_03864.txt

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+C3-C4: There is no evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.
+C4-C5: There is no evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.

paired_output/audio_03865.txt

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+PROTOCOL
+Multiplanar and multi-echo MRI of the cervical spine was performed without administration of intravenous contrast.
+
+FINDINGS
+Loss of cervical lordosis.
+Disc dessication noted .
+Soft tissue edema in paraspinal muscles.

paired_output/audio_03866.txt

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+C5-C6:  there is a right paracentral and foraminal disc herniation causing effacement of the right perineural fat with impingement of the exiting right C6 nerve root.

paired_output/audio_03867.txt

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+C6-C7: There is no evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.
+C7-T1: There is no evidence of disc disease or protrusion, central canal stenosis, or neural foraminal narrowing.

paired_output/audio_03868.txt

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+Cervical spinal cord shows normal MR morphology and signal characteristics.
+Posterior osseous structures and soft tissue structures are normal.
+Craniovertebral junction is normal. The cervico-medullary junction appears unremarkable.
+No pre / paraspinal soft tissue abnormality seen.

paired_output/audio_03869.txt

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+At the C6–C7 level, a posterior disc osteophyte complex causes mild indentation of the thecal sac without significant neural foraminal compromise or nerve root impingement.
+Soft tissue edema in paraspinal muscles.

paired_output/audio_03870.txt

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+IMPRESSION
+C5-C6:  there is a right paracentral and foraminal disc herniation causing effacement of the right perineural fat with impingement of the exiting right C6 nerve root.

paired_output/audio_03871.txt

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+Mild anterior wedge compression deformity of the C5 vertebral body is noted.
+Subtle STIR hyperintensity is seen within the odontoid process of C2, suggestive of focal marrow edema.

paired_output/audio_03872.txt

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+History of trauma.
+ 
+Mildly displaced fracture involving the visualised radial head.
+Mildly displaced fracture involving the olecranon process of ulna.
+Joint space appears normal.
+Articular margins are smooth and intact
+Soft tissues appear normal. 
+OPINION: 
+•	Mildly displaced fracture involving the visualised radial head.
+•	Mildly displaced fracture involving the olecranon process of ulna.

paired_output/audio_03873.txt

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+Great Vessels:
+Appear unremarkable.
+Visualized Upper Abdomen:
+A hypodense lesion measuring ~15 × 16 mm is seen in the upper pole of the spleen.
+Remaining visualized abdominal structures are unremarkable.
+Impression:

paired_output/audio_03874.txt

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+Multiple cavitary lesions with upper lobe predominance, associated with:
+Peribronchial scarring
+Fibro-atelectatic changes
+Numerous centrilobular/subcentimetric nodules
+-------CT Findings are may  suggest possibility of post-primary pulmonary infection, most likely:

paired_output/audio_03875.txt

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+Lungs & Airways:
+Multiple cavitary lesions of varying sizes are noted scattered in both lungs, predominantly involving the bilateral upper lobes.
+The largest cavity measures approximately 31 × 23 mm. in right upper lobe.
+Associated peribronchial scarring and fibro-atelectatic bands are seen in the involved regions.

paired_output/audio_03876.txt

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+Pleura:
+No pleural effusion or pleural thickening detected.
+Mediastinum & Hila:
+No significant mediastinal or hilar lymphadenopathy identified.
+Cardiac Findings:
+Cardiomegaly with dilatation of cardiac chambers noted.
+Mild pericardial effusion, measuring approximately 6.8 mm in thickness along the anterior aspect.

paired_output/audio_03877.txt

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+Recommendations:
+Correlate with:
+Sputum AFB / CBNAAT
+Bronchoscopy if indicated

paired_output/audio_03878.txt

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+→ Suggestive of small airway involvement / air trapping
+Cardiomegaly with mild pericardial effusion
+Small hypodense splenic lesion (~15 × 16 mm)
+Requires clinical correlation and further evaluation (USG/CECT if indicated)

paired_output/audio_03879.txt

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+Numerous small nodules are scattered throughout both lung fields; most are subcentimetric in size.
+Areas of mosaic attenuation are noted in both lungs, suggesting associated small airway disease or perfusion abnormalities.
+No obvious pneumothorax.
+No significant endobronchial lesion identified.

paired_output/audio_03880.txt

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+Post-primary pulmonary tuberculosis with endobronchial spread
+Differentials :
+Necrotizing bacterial infection
+Fungal infection
+Less likely cavitating metastases (depending on clinical context)
+Mosaic attenuation pattern in bilateral lungs

paired_output/audio_03881.txt

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+FINDINGS
+
+Frontal and maxillary sinuses appear normal.
+No evidence of any bony abnormality seen.
+Soft tissues appear normal.
+Mild deviation of nasal septum to right.

paired_output/audio_03882.txt

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+Left inferior turbinate hypertrophy.
+
+IMPRESSION
+Mild deviation of nasal septum to right.
+Left inferior turbinate hypertrophy.
+
+DIFFERENTIAL DIAGNOSIS
+NA
+
+RECOMMENDATION
+Suggested clinical correlation & CT facial bone to rule out undisplaced fracture

paired_output/audio_03883.txt

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+The liver is normal in size and attenuation.
+Spleen is mildly enlarged and measures approximately 12.5 cm. No obvious focal lesion.
+The pancreas, and both adrenal glands appear unremarkable.
+The gallbladder is distended with minimal sludge within the lumen.
+The common bile duct is normal in caliber.

paired_output/audio_03884.txt

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+A 4.7 x 3.1 x 7.1 mm sized hyperdense (HU 850) obstructive calculus noted in the right midureter (at level of right iliac crossing, at L5-S1 level) with resultant back pressure changes in the form of proximal hydroureter and mild hydronephrosis.

paired_output/audio_03885.txt

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+A 4.6 mm sized hyperdense non-obstructive calculus is noted in the mid calyx of left kidney. Both kidneys are otherwise normal in size, shape, and location with normal enhancement. No left hydronephrosis or focal lesion is seen.
+The urinary bladder is normal in size and wall thickness.
+Anterior abdominal wall:

paired_output/audio_03886.txt

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+No communication with bowel or urinary bladder is identified. However there is elongated structure seen at hilum.
+Mild fat stranding is seen at the umbilicus.
+Bladder is connected to umbilicus by linear brands and elongated bladder structure seen as a diverticulum.
+No loculated collection or surrounding inflammatory changes are noted.

paired_output/audio_03887.txt

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+A thin linear hypodense tract is seen in the infraumbilical region along the anterior abdominal wall. On administration of contrast through the umbilicus, contrast opacification is seen extending into the deep subcutaneous plane at the umbilicus without extension into the intraperitoneal cavity.

paired_output/audio_03888.txt

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+No significant lymphadenopathy or ascites is seen.
+Impression:
+Contrast-filled blind-ending tract at the umbilicus extending into the deep subcutaneous plane without intraperitoneal communication — suggestive of umbilical sinus, likely urachal sinus. No contrast opacification beyond the umbilicus.

paired_output/audio_03889.txt

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+Bladder is connected to umbilicus by linear obliterated bran.
+No evidence of enteric or vesical communication.
+Distended gallbladder with minimal sludge.
+A 4.7 x 3.1 x 7.1 mm sized hyperdense (HU 850) obstructive calculus

paired_output/audio_03890.txt

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+noted in the right midureter (at level of right iliac crossing, at L5-S1 level) with resultant back pressure changes in the form of proximal hydroureter and mild hydronephrosis.
+Left renal non-obstructive calculus.
+Otherwise unremarkable CT abdomen.