I would like to know what this radiologist's report means in layman's terms.

CT Chest without contrast

Multiple contiguous axial images were acquired through the patient?s
chest use of P/ contrast agent. Comparison is with previous two-view
chest x-ray from 06/23/04 and 06/01/04.

The examination demonstrates mild bibasilar interstitial infiltrates
without evidence of alveolar consolidation. There are also markings at
the mid and anterior left base which are somewhat more coarse
suggesting atelectasis and/or scarring. There is no discrete evidence
of pleural efftusion or pneumothorax No discrete obstructive mass or
nodule is seen and no non-obstructive masses or nodules are
appreciated. No discrete mediastinal or hilar adenopathy is seen.
Visualized portions of the abdomen are unremarkable, somewhat limited
by lack of IV contrast agent. There is suggestion of a very tiny
hiatal hernia.

1MPRESS1ON~
Mild posterior bibasilar interstitial infiltrates wthout evidence of
underlying mass lesion When compare with the patient?s chest x-ray
from 06/23/04, there has been no significant resolution.

Dear rbischoff,

Please read the Important Disclaimer at the bottom of this page, and
bear in mind that what I have to say is no substitute for a medical
professional's advice. However, I am pleased to research the terms
contained in the radiologist's report and present to you
my findings.

First, CT is computerized tomography, a method for obtaining X-rays of
specific cross-sections, or slices, of an organ.

ct
http://dictionary.reference.com/search?q=ct

tomography
http://dictionary.reference.com/search?q=tomography

The qualifier "without contrast" means that the radiologist did not administer
a barium solution or other dye to the patient before the scan. When such liquid
is employed, it flows through blood vessels in the organ of interest
to make it show up more vividly in the CT scan.

Baptist Health Systems: CT Head with and without Contrast
http://www.mbhs.org/health_topics/ct_exams/head_with_wo_contrast.htm

An axial image is one that is taken at a certain angle with respect to
an axis of rotation, and contiguous means that they were taken
side-by-side. In other words, while the CT machine moved in an arc
over the patient's chest, it made several scans in quick succession to
obtain a three-dimensional view of the area.

University of Maryland Medicine: What is a CT or CAT scan?
http://www.umm.edu/radiology/ct.htm

I can't tell what the phrase "use of P/ contrast agent" means, since
it makes the sentence ungrammatical. In any case, the title and a
later mention in the
report make it clear that no contrast agent was used. Are you sure this phrase
is supposed to be part of the same sentence? The next sentence mentions a
comparison with previous x-rays, which is clear enough.

The following paragraph is the important one, and in it especially the
first sentence. There's a lot of jargon at play in "mild bibasilar
interstitial infiltrates without evidence of alveolar consolidation",
which just hides the fact that the radiologist is giving rather vague
impressions of a physical phenomenon in the patient's lungs.

"Bibasilar" refers to something going on at the base of both lungs.
That something is "interstitial infiltrates", which means that an
indeterminate substance has accumulated in spaces between the lung
tissue. An "infiltrate" is an abnormal substance that shouldn't be
there, while "interstitial" means literally "in the spaces between".
The alveola are the little air sacs in the lungs, so if there's no
alveolar consolidation, the abnormal substance has not collected in
the air sacs.

basilar
http://dictionary.reference.com/search?q=basilar

interstitial
http://dictionary.reference.com/search?q=interstitial

infiltrate
http://dictionary.reference.com/search?q=infiltrate

alveolus
http://dictionary.reference.com/search?q=alveolus

Then the radiologist notes "markings at the mid and anterior left
base", by which he means the middle and front of the left lung, near
its base. He observes that the markings may have been left by some
past trauma, since they resemble scars or the traces of a collapsed
lung.

anterior
http://dictionary.reference.com/search?q=anterior

atelectasis
http://dictionary.reference.com/search?q=atelectasis

In the sentence after that, the radiologist says that he sees no
"discrete evidence", or nothing that would in itself lead him to
believe that there was "pleural effusion or pneumothorax". Pleural
effusion would be fluid seeping from the membrane around the lungs,
while pneumothorax is an accumulation of gas inside the lungs.
Further, in speaking of "masses or nodules", he says that he does not
perceive any lumps, knots, or other kinds of growths, whether blocking
the lungs or not.

discrete
http://dictionary.reference.com/search?q=discrete

pleura
http://dictionary.reference.com/search?q=pleura

pneumothorax
http://dictionary.reference.com/search?q=pneumothorax

effusion
http://dictionary.reference.com/search?q=effusion

nodule
http://dictionary.reference.com/search?q=nodule

Nor does the radiologist see an enlargement of the lymph nodes
(adenopathy) between the lungs (mediastinal) or where the air passage
enters the lungs (hilar).

mediastinal
http://dictionary.reference.com/search?q=mediastinal

hilar
http://dictionary.reference.com/search?q=hilar

adenopathy
http://dictionary.reference.com/search?q=adenopathy

There is nothing to remark about the parts of the abdomen he can see,
says the radiologist, but then he can't see much because no dye was
administered. What he does detect are possible signs of a hiatal
hernia, a "very tiny" one. A hiatal hernia is not as scary as it
sounds, according to the Mayo Clinic. It involves the protrusion of a
portion of the stomach into the chest cavity, which tends to cause no
symptoms and occurs in "about one-quarter of people older than 50".

Mayo Clinic: Hiatal hernia
http://www.mayoclinic.com/invoke.cfm?id=DS00099

In conclusion, the radiologist repeats that there are "mild posterior
bibasilar interstitial infiltrates", or small quantities of an
abnormal substance occurring in the spaces between the tissue at the
base of both lungs. He does not detect "mass lesion", or widespread,
diseased change of the lung tissue. Finally, there is no "resolution"
compared to the earlier x-rays, meaning that the phenomenon there
detected has not yet cleared up.

lesion
http://dictionary.reference.com/search?q=lesion

resolution
http://dictionary.reference.com/search?q=resolution

By way of summary, let me paraphrase the whole of the report's central paragraph.

    The examination shows some presence of an abnormal substance at 
    the base of both lungs, occurring in the spaces between the
    tissues, but it appears that this substance has not collected
    in the air sacs. There are coarser markings at the base of the
    left lung, in the middle and front, that could possibly be scars
    or the traces of an earlier lung collapse. There are no special
    signs of fluid seeping into the lungs or gas accumulating in
    the lungs. There are no tissue growths blocking the lungs, and
    it appears that there are no tissue growths altogether. There
    are no enlarged lymph nodes between or above the lungs. There
    is not much to say about the abdomen, although a dye might have
    helped to see more. It's possible that a very small part of the
    stomach is protruding into the chest cavity.

If you feel that my answer is incomplete or inaccurate in any way, please
post a clarification request so that I have a chance to meet your needs
before you assign a rating.

Regards,

leapinglizard

---

Request for Answer Clarification by rbischoff-ga on 11 Sep 2004 08:08 PDT

Your answer is very helpful.  Now could you tell me what it means in
terms of my health.  I am trying to educate myself before a visit to
my doctor on Thursday.

i.e.  what do these results tell my doctor.  

Thanks.

Richard

---

Clarification of Answer by leapinglizard-ga on 11 Sep 2004 08:31 PDT

I'm not a doctor, nor is a radiologist a doctor. The only person
qualified to tell you how this CT scan relates to your medical history
is your doctor. My services as a Researcher extend only to translating
the radiologist's report into layman's terms, and not to offering a
diagnosis or prognosis of anyone's health. Only a medical professional
is able and permitted to do that.

As a human being, I can tell you that if I received a report such as
the above, I would not lose any sleep over it. It describes a mild
condition, and takes pains to point out the absence of any visible
tissue pathology. If my lungs were diseased and the tissues were
mutating or the surrounding lymph nodes were swelling, I'd be worried.
According to the report, however, this is not the case. But that's
just how I would feel in a hypothetical situation, and I'm not you.
Please wait and see what your doctor says. I wish you the best of
health.

leapinglizard

Leapinglizard,

Your statement that a radiologist is not a doctor may be true in your
part of the world, but in the United States, radiologists are doctors.

http://www.viahealth.org/disease/radiology/doc.htm

You're quite right, pinkfreud, and I apologize for the misstatement. A
radiologist is indeed a medical doctor, if not necessarily the
patient's personal doctor. I stand by the rest of my statement.

leapinglizard