What is a radiology report?
The short answer
A radiology report is the signed, written interpretation of an imaging study by a physician, usually a radiologist. The ACR Practice Parameter for Communication of Diagnostic Imaging Findings (revised 2025) calls the final report “the definitive documentation of the results of an imaging examination or procedure” and suggests a standard format: demographics, relevant clinical information, the procedures and materials used, findings, limitations, the clinical question, comparison studies, and an impression.
- 6core sections in almost every report
- 1impression: the conclusion
- Finalthe signed report of record
The standard parts of a radiology report
The ACR practice parameter lists the components of a report as a suggested format, not a fixed template. Most hospitals and radiology groups turn it into the section headings below, and many use standardized templates, such as the free RSNA RadReport template library, to keep the order the same from one report to the next.
| Section | What it holds | Where the ACR covers it |
|---|---|---|
| Exam | The name of the study, for example CT head without contrast | Demographics: name or type of examination |
| Clinical history | Why the study was ordered: symptoms and the question to answer | Relevant clinical information; clinical issues |
| Comparison | Prior studies the radiologist reviewed, or “none available” | Comparison studies and reports |
| Technique | How the study was done: contrast, dose, sequences, reconstructions | Procedures and materials |
| Findings | What the radiologist saw, organized by organ or region | Findings; potential limitations |
| Impression | The conclusion: diagnosis, differential, recommended follow-up | Impression (conclusion or diagnosis) |
Around those six sections, the report also carries a header (patient, ordering provider, exam date and time) and an electronic signature with the time the report was finalized. When a finding needs urgent action, a documented communication line is added.
How to read each section
- Exam
- Tells you what was imaged and how: body part, modality (CT, MRI, X-ray, ultrasound) and whether contrast was used. “W” means with contrast; “WO” means without.
- Clinical history
- The question the radiologist was asked. A report answers the question it was given, so a precise history gets a more useful report. The ACR notes that a request for imaging should include pertinent signs and symptoms and, ideally, a specific question.
- Comparison
- Whether earlier images were available. Change over time is often the most important finding, so “none available” matters: a finding with no prior to compare against is harder to call old or new.
- Technique
- The recipe for the study: contrast agent and volume, dose reduction, MRI sequences, reconstructions. Mostly for clinicians and later radiologists; it explains what the study could and could not show.
- Findings
- A structured walk through each organ or region. “Unremarkable” means normal. Positive findings come with size, location and features; normal structures are listed to show they were checked.
- Limitations
- Anything that reduced the quality of the study, such as motion, bowel gas or no contrast. The ACR asks reports to identify factors that may compromise sensitivity and specificity.
- Impression
- The answer. If you read one section, read this one. It gives a specific diagnosis when possible, a differential when not, and follow-up when the radiologist recommends it. It is often numbered, most important first.
- Signature
- The name of the interpreting physician and when the report was signed. A signed final is the report of record; an unsigned or preliminary report is not.
A practical order for busy readers: impression first, then the findings behind each impression line, then the history and comparison to understand the context.
Example: CTA head and neck (stroke)
CT angiography looks for a blocked or narrowed artery. This example finds a large vessel occlusion, a result on most hospitals’ critical list.
EXAM:CTA HEAD AND NECK W AND WO CONTRAST
CLINICAL HISTORY:Code stroke. Sudden right-sided weakness and aphasia. Last known well [time].
COMPARISON:None.
TECHNIQUE:Noncontrast axial CT of the head was performed, followed by CT angiography of the head and neck after intravenous administration of 75 mL Omnipaque 350. 3D maximum intensity projection and multiplanar reconstructions were created on an independent workstation. One or more dose reduction techniques were used (automated exposure control, adjustment of mA/kV according to patient size, iterative reconstruction).
FINDINGS:NONCONTRAST HEAD: No intracranial hemorrhage, mass effect or midline shift. Gray-white matter differentiation is preserved. ASPECTS 10.
CTA HEAD: Abrupt occlusion of the proximal left M1 segment of the middle cerebral artery, with diminished opacification of distal left MCA branches. Right MCA, both anterior cerebral arteries and the posterior circulation are patent. No aneurysm.
CTA NECK: Normal aortic arch branching. Common and internal carotid arteries are patent without hemodynamically significant stenosis by NASCET criteria. Vertebral arteries are patent.
OTHER: Visualized lung apices are clear.
IMPRESSION:Acute occlusion of the proximal left M1 segment (large vessel occlusion).
No intracranial hemorrhage. ASPECTS 10.
No hemodynamically significant cervical carotid stenosis.
CRITICAL RESULT:The findings above were communicated by telephone to the ED physician at [time] with read-back confirmation.
SIGNATURE:Electronically signed by: [radiologist], MD · Board-certified radiologist · Signed [time]
Illustrative report from our sample reads, fictional patient. Patient header, names, dates and times removed.
What to notice: the findings are split by territory (head, neck), and the critical result line records who was told, how, when, and that they read it back. See the full signed version on our sample reads.
Example: CT abdomen and pelvis
The workhorse of the emergency department for abdominal pain. The findings run organ by organ, so a normal organ is still listed as checked.
EXAM:CT ABDOMEN AND PELVIS W CONTRAST
CLINICAL HISTORY:Right lower quadrant pain, fever and leukocytosis.
COMPARISON:None.
TECHNIQUE:Axial CT of the abdomen and pelvis was performed after intravenous administration of 100 mL Omnipaque 300. Coronal and sagittal reformats were reviewed. One or more dose reduction techniques were used (automated exposure control, adjustment of mA/kV according to patient size, iterative reconstruction).
FINDINGS:LOWER CHEST: Clear lung bases.
APPENDIX: Dilated appendix measuring 12 mm, with wall thickening, mucosal hyperenhancement and periappendiceal fat stranding. No periappendiceal abscess. No extraluminal air.
LIVER, GALLBLADDER, SPLEEN, PANCREAS, ADRENALS: Unremarkable.
KIDNEYS: No hydronephrosis or renal calculus.
BOWEL: No bowel obstruction.
PERITONEUM AND PELVIS: Trace free fluid in the right paracolic gutter. Urinary bladder is unremarkable.
LYMPH NODES: Few subcentimeter right lower quadrant mesenteric lymph nodes, likely reactive.
BONES: No acute osseous abnormality.
IMPRESSION:Acute uncomplicated appendicitis. No abscess or perforation.
CRITICAL RESULT:The findings above were communicated by telephone to the ED physician at [time] with read-back confirmation.
SIGNATURE:Electronically signed by: [radiologist], MD · Board-certified radiologist · Signed [time]
Illustrative report from our sample reads, fictional patient. Patient header, names, dates and times removed.
What to notice: “uncomplicated” and “no abscess or perforation” in the impression answer the surgeon’s next question before it is asked.
Example: chest X-ray
Plain films produce the shortest reports. Technique is one line, and the findings are grouped by lungs, mediastinum and bones.
EXAM:XR CHEST 1 VIEW (PA UPRIGHT)
CLINICAL HISTORY:Sudden left-sided chest pain and shortness of breath.
COMPARISON:None available.
TECHNIQUE:Single upright PA view of the chest.
FINDINGS:LUNGS AND PLEURA: Large left pneumothorax with a visible visceral pleural line and absent lung markings peripherally. The left lung is partially collapsed. Right lung is clear. No pleural effusion.
MEDIASTINUM: Mild rightward mediastinal shift. Heart size is normal.
BONES: No displaced rib fracture.
IMPRESSION:Large left pneumothorax with mild rightward mediastinal shift.
CRITICAL RESULT:The findings above were communicated by telephone to the ED physician at [time] with read-back confirmation.
SIGNATURE:Electronically signed by: [radiologist], MD · Board-certified radiologist · Signed [time]
Illustrative report from our sample reads, fictional patient. Patient header, names, dates and times removed.
What to notice: pneumothorax is one of the examples the ACR gives of a finding that may need immediate intervention, so even a one-view X-ray carries a documented call.
Example: MRI lumbar spine
MRI reports are organized by level or structure. Spine reports go disc level by disc level, which makes the impression easy to trace back.
EXAM:MRI LUMBAR SPINE WO CONTRAST
CLINICAL HISTORY:Low back pain radiating down the left leg for six weeks.
COMPARISON:None available.
TECHNIQUE:Multiplanar, multisequence MRI of the lumbar spine was performed without intravenous contrast.
FINDINGS:ALIGNMENT: Normal lumbar lordosis. No spondylolisthesis.
VERTEBRAE AND MARROW: Vertebral body heights are maintained. Normal marrow signal.
CONUS: Terminates normally at L1.
L1-L2 THROUGH L3-L4: No significant disc bulge, canal stenosis or foraminal narrowing.
L4-L5: Left paracentral disc extrusion with mild inferior migration, narrowing the left lateral recess and contacting the traversing left L5 nerve root. Mild facet arthropathy. No significant foraminal stenosis.
L5-S1: Mild disc desiccation with a minimal bulge. No stenosis.
PARASPINAL SOFT TISSUES: Unremarkable.
IMPRESSION:L4-L5 left paracentral disc extrusion with impingement of the traversing left L5 nerve root.
No high-grade canal stenosis.
SIGNATURE:Electronically signed by: [radiologist], MD · Board-certified radiologist · Signed [time]
Illustrative report from our sample reads, fictional patient. Patient header, names, dates and times removed.
What to notice: the impression names the level, the side and the nerve root, the three things a spine clinic needs to plan care.
Preliminary vs final reports
Not every report you see is the final word. The ACR practice parameter describes a preliminary report as one that precedes the final report, “for the purpose of directing immediate patient management”, and says it “very likely will contain limited or incomplete information.” A preliminary report should be labeled as preliminary, kept distinct from the final, and archived, because clinical decisions may have been based on it.
Preliminary report
- Issued first, to guide immediate care
- May answer only the urgent question
- Labeled preliminary and archived separately
- A second read and signature are still pending
Final report
- The definitive record of the study
- Covers every finding, including incidental ones
- Proofread and signed by the interpreting physician
- Any change from a prelim is called and documented in the final
When the final differs significantly from the preliminary, the ACR expects that change to be reported to the treating clinician and documented in the final report. Every TeleRads report is a signed final; we read finals only, never preliminaries. Read more in preliminary vs final radiology reads.
Critical results language in a report
When a finding needs urgent action, the report records that it was communicated, not only what was found. The ACR practice parameter says interpreting physicians should document all nonroutine communications, and gives the date and time, the method of communication and the name of the person who received it as an example of that documentation. Its examples of urgent findings include pneumothorax, pneumoperitoneum and a significantly misplaced line or tube.
- What was found, usually “the findings above”.
- How it was communicated: by telephone or in person.
- To whom: the name and role of the clinician who took the call.
- When: the date and time of the call.
- Read-back: confirmation that the receiver repeated the result.
A typical line reads: “CRITICAL RESULT: The findings above were communicated by telephone to the ED physician at [time] with read-back confirmation.” Hospitals also have their own duties under the Joint Commission’s National Patient Safety Goals to report critical results on a timely basis. TeleRads calls critical results within 15 minutes and logs every call. See critical results communication in radiology.
Common words in radiology reports
| Term | What it usually means |
|---|---|
| Unremarkable | Normal; nothing of concern seen |
| No acute abnormality | Nothing new or urgent; older or chronic findings may still be listed |
| Incidental finding | Something found that is unrelated to why the study was ordered |
| Cannot be excluded | The study cannot rule it out; more testing may help |
| Clinical correlation | Compare with the exam, symptoms and labs before acting |
| Hyperdense / hypodense | Brighter or darker than surrounding tissue on CT |
| Hyperechoic / hypoechoic | Brighter or darker than surrounding tissue on ultrasound |
| Hyperintense / hypointense | Brighter or darker than surrounding tissue on MRI |
| Enhancement | Tissue that brightens after contrast is given |
Patients increasingly see their reports in a patient portal, sometimes before their doctor does. The ACR recommends that imaging reports be made readily available to patients. Reports are written for clinicians, so a report is best read alongside the clinician who ordered the study.
How TeleRads reports
- Signed finals by board-certified radiologists, so there is one report in the chart.
- Your templates and your section order, so a night read looks like a day read.
- Your critical results list, with every call read back and logged with name, role and time.
- Criticals called within 15 minutes, and stroke studies read first.
See ten complete examples, critical and routine, each shown as the signed report your ED would get, on our sample reads page.
Questions
What is a radiology report?
A radiology report is the written interpretation of an imaging study by a physician, usually a radiologist. The signed final report is the official record of what the images show. It normally includes the exam, clinical history, comparison, technique, findings and impression.
What are the parts of a radiology report?
Most reports have six core sections: exam, clinical history, comparison, technique, findings and impression. They also carry a header with the patient and ordering provider and an electronic signature. The ACR practice parameter on communication of diagnostic imaging findings describes these components as a suggested format.
What is the most important part of a radiology report?
The impression. It is the radiologist’s conclusion: a specific diagnosis when possible, a differential when not, and any recommended follow-up. The findings section explains how the radiologist got there.
What does unremarkable mean on a radiology report?
Unremarkable means normal: the radiologist looked at that structure and saw nothing of concern. Reports list normal structures to show they were checked, not because something is wrong.
What is the difference between a preliminary and a final radiology report?
A preliminary report is an early interpretation issued to guide immediate care, and it may be incomplete. The final report is the signed, complete record. If the final differs significantly from the preliminary, the change should be communicated to the treating clinician and documented in the final report.
How are critical findings documented in a radiology report?
The report records that the finding was communicated, how, to whom and when, usually with a read-back confirmation. The ACR practice parameter gives the date and time, the method and the name of the person told as an example of that documentation.
Are the sample reports on this page real?
No. All four are adapted from the illustrative cases on our sample reads page. Every example uses a fictional patient and contains no patient information.