| Case ID: | Facility: | Accession ID: | Station: | ||||||
| Instructions: Provide an initial impression and generate findings -OR- enter findings directly. |
| IMPRESSION: | ||
| AGE |
<20
20-50
>50
|
|
| FINDINGS: | ||
| FLAIR |
Increased
Normal
Decreased
|
|
| T2 |
Increased
Normal
Decreased
|
|
| T1 |
Increased
Normal
Decreased
|
|
| Contrast Enhancement |
Yes
No
|
|
| Susceptibility Artifact |
Yes
No
|
|
| Diffusion |
Restricted
Normal
Facilitated
|
|
| Dominant Pattern |
Homogeneous
Ring
Heterogeneous
|
|
| Number of Lesions |
Single
Multiple
|
|
| CHANGES: | |
| Post-operative | |
|
Expected
Not Expected
|
|
| From previous exam | |
|
No
Yes
|
|
|
Increased
Decreased
|
|
|
Size
Number
Signal Intensity
|
| Side |
L
R
Bilateral Asymmetric
Bilateral Symmetric
|
| Location
|
|
| Size (cm) |
≤1 cm
>1 cm - 3 cm
>3 cm
Maximum Diameter
|
| Mass Effect |
+
None
-
|
|
1st Clinical Diagnosis
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|
|
2nd Clinical Diagnosis
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|
|
3rd Clinical Diagnosis
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| Drag and drop from the probability scores onto your decision selections to override the Decision Support System | |||
| Radiographic Score | Clinical Score | ||
| Case ID: | Facility: | Accession ID: | Station: | ||||||