Many patients now see a radiology report online before they have spoken to anyone, and the language can be startling. Words like "unremarkable", "lesion" and "incidental" read very differently when you are the person being described. This page explains how a typical report is organised, what each part is for and how reports reach patients. It cannot interpret any individual report, and it does not try to. Your doctor, or the radiology team at your facility, is the right person to explain yours.
Who writes the report and who it is for
A radiologist is a doctor who supervises imaging exams, reads and interprets the images, and writes a report. RadiologyInfo.org, the patient site run by the Radiological Society of North America and the American College of Radiology, says the report is written for the healthcare provider who ordered the exam, who then delivers the results to you. In most practices it still uses medical terms that your provider will understand but that may be confusing to you.
Once the report is complete the radiologist signs it and sends it to your doctor, who will discuss the results with you. The NHS in England describes the same path for CT scans: the images are looked at by a specialist radiologist, who writes to the doctor who referred you, and a follow-up appointment may be needed to talk about the results. For that service it says results usually take between 1 and 2 weeks but can take up to 4 weeks, depending on how urgent the scan is and where you live. Timing is a local matter, so ask your imaging team what to expect.
The usual sections
Layouts vary, but RadiologyInfo.org lists the sections that most reports share, and reading them in order helps. The first is the type of exam, which usually shows the date, time and type of scan, for example a CT of the abdomen and pelvis with contrast. Next comes the history or reason for the exam, which is the information your ordering provider gave the radiologist about your symptoms and why the test was requested. It helps the radiologist focus the report.
The comparison or "priors" section lists any earlier imaging the radiologist compared with the new scan, usually of the same body area and exam type. The source adds that it is always a good idea to get prior exams from other hospitals and give them to the department where you are having your test, because older exams can be very helpful to the radiologist. The technique section records how the exam was done and whether contrast was injected into a vein. RadiologyInfo.org notes that it exists for documentation, so it is not typically useful for you or your doctor, though it can help a radiologist with a future exam.
Findings: what was seen, area by area
The findings section lists what the radiologist saw in each area covered by the exam and whether they think the area is normal, abnormal or potentially abnormal. It can be written in paragraphs or as a line for each organ or region. Two points from the source are worth knowing. If an area is covered but nothing is said about it, that usually means the radiologist looked and found no problems to tell your doctor. And if nothing concerning is seen, the report may say "normal" or "unremarkable", which the page uses as a plain synonym for normal.
The source shows an invented sample, clearly marked as not a real report, in which individual organs get one line each and a few small items are described as "likely" benign. Such hedged wording is typical, because imaging shows appearances rather than the cause of an appearance. Terms like "probable" or "likely" describe the radiologist's level of confidence, and what to do about them is a decision for you and your doctor.
Impression: the summary section
The impression is where the radiologist summarises the findings, reports the most important ones and lists possible causes, which the source calls a differential diagnosis. RadiologyInfo.org says this section offers the most important information for decision-making, which makes it the most important part of the report for you and your doctor. If you read only one section, this is the one that was written for that purpose, but even so it should be read alongside your symptoms and history rather than on its own.
For an abnormal or potentially abnormal finding, the radiologist may recommend other imaging that can assess the finding better, a follow-up scan to look again after a period of time, a biopsy, comparison with other imaging the radiologist cannot see, or correlation of the finding with your symptoms or laboratory results. The last of these exists to help decide whether a finding is likely to be incidental. The source states plainly that many findings a radiologist sees on a scan are incidental and will cause you no harm. A recommendation for more tests is therefore part of careful reporting, not a verdict.
The same page adds that sometimes a report does not answer the clinical question, and more exams may be needed. It also notes that you may be reading the report before your own provider has seen it, because many patients can now access their health records online straight away. If that happens, it can help to remember that the report was not written to you. The questions on the page about questions to ask before a scan include several worth asking about results.
Getting answers when the wording is unclear
RadiologyInfo.org's advice is simple: if the report contains complex words, talk to your provider or ask to speak to a radiologist. It also says that if your physician cannot answer your questions, you can talk to your facility's imaging staff, and that many radiologists are happy to answer questions. Policies differ between facilities and countries, so it is reasonable to ask how that works where you are being scanned. The wider picture of what happens from appointment to result is on the page about preparing for a scan and your results, and the people involved at the scanner itself are described under what a radiologic technologist does.
Frequently asked questions
What does "unremarkable" mean on a radiology report?
RadiologyInfo.org uses it as a synonym for "normal" in the findings section, as in "spleen: unremarkable (normal)". It describes what the radiologist saw in that area on that scan.
What is an incidental finding?
It is something seen on the scan that was not the reason for the exam. RadiologyInfo.org says many such findings are incidental and will cause you no harm, and that the radiologist may suggest correlating them with your symptoms to judge whether they matter.
Why does my report recommend a follow-up scan?
The source says follow-up imaging can look again at a finding after a period of time, or give a better assessment of it. Your doctor will explain why one is suggested in your case.
Can I ask the radiologist to explain my report?
RadiologyInfo.org suggests asking your provider first, and says that if they cannot answer, you can talk to your facility's imaging staff, adding that many radiologists are happy to answer questions. Arrangements differ between facilities.
The short version
A radiology report is a document written by a radiologist for the doctor who ordered the scan, with sections for the exam, the reason, comparisons, technique, findings and a summarising impression. Cautious wording and recommendations for further tests are normal features of the genre. If the language confuses you, the people to ask are your own doctor or your imaging facility's staff.