diff --git a/app/Database/Seeds/LabTemplateSeeder.php b/app/Database/Seeds/LabTemplateSeeder.php index 010d0c5..c1d9581 100644 --- a/app/Database/Seeds/LabTemplateSeeder.php +++ b/app/Database/Seeds/LabTemplateSeeder.php @@ -83,6 +83,9 @@ class LabTemplateSeeder extends Seeder $this->db->query('SET FOREIGN_KEY_CHECKS = 1'); $this->db->query('SET SESSION SQL_MODE = @OLD_SQL_MODE'); + // Seed comprehensive X-Ray, CT-Scan, and MRI templates + service charges + $this->call(RadiologyTemplatesSeeder::class); + CLI::write('Lab template seeder complete.', 'green'); } diff --git a/app/Database/Seeds/RadiologyTemplatesSeeder.php b/app/Database/Seeds/RadiologyTemplatesSeeder.php new file mode 100644 index 0000000..78425e7 --- /dev/null +++ b/app/Database/Seeds/RadiologyTemplatesSeeder.php @@ -0,0 +1,472 @@ +db; + + if (! $db->tableExists('radiology_ultrasound_template')) { + CLI::write('Table radiology_ultrasound_template does not exist. Skipping.', 'red'); + return; + } + + $now = date('Y-m-d H:i:s'); + + // --------------------------------------------------------------------- + // 1. Ensure Charge Services exist in `hc_items` + // --------------------------------------------------------------------- + $services = [ + // X-Ray (itype = 3) + ['itype' => 3, 'desc' => 'X-RAY CHEST PA VIEW', 'amount' => 350.00], + ['itype' => 3, 'desc' => 'X-RAY CHEST AP VIEW', 'amount' => 350.00], + ['itype' => 3, 'desc' => 'X-RAY BOTH KNEE JOINTS AP & LATERAL', 'amount' => 500.00], + ['itype' => 3, 'desc' => 'X-RAY LS SPINE AP & LATERAL', 'amount' => 600.00], + ['itype' => 3, 'desc' => 'X-RAY CERVICAL SPINE AP & LATERAL', 'amount' => 550.00], + ['itype' => 3, 'desc' => 'X-RAY ABDOMEN ERECT (KUB)', 'amount' => 450.00], + ['itype' => 3, 'desc' => 'X-RAY PNS (WATER\'S VIEW)', 'amount' => 400.00], + ['itype' => 3, 'desc' => 'X-RAY PELVIS WITH BOTH HIPS AP', 'amount' => 500.00], + + // CT-Scan (itype = 4) + ['itype' => 4, 'desc' => 'NCCT HEAD / BRAIN', 'amount' => 1800.00], + ['itype' => 4, 'desc' => 'NCCT HEAD (STROKE PROTOCOL)', 'amount' => 2000.00], + ['itype' => 4, 'desc' => 'HRCT CHEST / THORAX', 'amount' => 2500.00], + ['itype' => 4, 'desc' => 'CECT WHOLE ABDOMEN & PELVIS', 'amount' => 4500.00], + ['itype' => 4, 'desc' => 'NCCT KUB (KIDNEYS, URETERS, BLADDER)', 'amount' => 2200.00], + ['itype' => 4, 'desc' => 'CECT CHEST', 'amount' => 3500.00], + ['itype' => 4, 'desc' => 'NCCT CERVICAL / LUMBAR SPINE', 'amount' => 2500.00], + + // MRI (itype = 2) + ['itype' => 2, 'desc' => 'MRI BRAIN (PLAIN STUDY)', 'amount' => 4000.00], + ['itype' => 2, 'desc' => 'MRI BRAIN (STROKE / DWI PROTOCOL)', 'amount' => 4500.00], + ['itype' => 2, 'desc' => 'MRI LUMBOSACRAL (LS) SPINE', 'amount' => 4200.00], + ['itype' => 2, 'desc' => 'MRI CERVICAL SPINE', 'amount' => 4200.00], + ['itype' => 2, 'desc' => 'MRI KNEE JOINT (RIGHT / LEFT)', 'amount' => 4500.00], + ['itype' => 2, 'desc' => 'MRI WHOLE SPINE SCREENING', 'amount' => 5500.00], + ['itype' => 2, 'desc' => 'MRI SHOULDER JOINT', 'amount' => 4500.00], + ]; + + $chargeIdMap = []; + if ($db->tableExists('hc_items')) { + foreach ($services as $svc) { + $existing = $db->table('hc_items') + ->where('itype', $svc['itype']) + ->where('idesc', $svc['desc']) + ->get(1) + ->getRowArray(); + + if (! empty($existing['id'])) { + $chargeIdMap[$svc['desc']] = (int) $existing['id']; + } else { + $db->table('hc_items')->insert([ + 'itype' => $svc['itype'], + 'idesc' => $svc['desc'], + 'amount' => $svc['amount'], + 'amount_r' => 0.00, + 'echs_sr_no' => 0, + 'update_date' => $now, + 'last_update_desc' => 'Seeded by RadiologyTemplatesSeeder', + ]); + $chargeIdMap[$svc['desc']] = (int) $db->insertID(); + } + } + } + + // --------------------------------------------------------------------- + // 2. Master Templates List + // --------------------------------------------------------------------- + $templates = [ + + // ================================================================= + // X-RAY TEMPLATES (Modality = 3) + // ================================================================= + [ + 'template_name' => 'X-RAY CHEST PA VIEW (Normal)', + 'title' => 'X-Ray Chest PA View', + 'keywords' => 'chest, pa view, lungs, heart, normal, thorax, pulmonary, rib cage', + 'Modality' => 3, + 'service_key' => 'X-RAY CHEST PA VIEW', + 'Findings' => <<TRACHEA & MEDIASTINUM : Trachea is central in position. Mediastinum shows normal configuration with no shift or widening.
+CARDIAC SILHOUETTE : Heart size is within normal limits. Cardio-thoracic ratio (CTR) is less than 0.5. Aortic knuckle appears unremarkable.
+LUNG PARENCHYMA : Both lung fields are clear with normal bronchovascular arborization. No focal parenchymal consolidation, mass, cavitation, or active infiltration seen.
+HILAR REGIONS : Bilateral hilar shadows are normal in size, density, and configuration with no evidence of lymphadenopathy.
+COSTOPHRENIC & CARDIOPHRENIC ANGLES : Both CP and cardiophrenic angles are acute, clear, and sharp. No evidence of pleural effusion or pleural thickening.
+DIAPHRAGMS : Both domes of diaphragm are smooth, convex, and normal in position.
+BONES & SOFT TISSUES : Visualized thoracic rib cage, clavicles, and soft tissues appear unremarkable. No focal bone erosion or fracture identified.
+HTML + , + 'Impression' => 'Normal study of Chest (PA View). No active cardiopulmonary lesion detected.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'X-RAY CHEST PA VIEW - Pneumonia / Consolidation', + 'title' => 'X-Ray Chest PA View - Pneumonia', + 'keywords' => 'chest, pneumonia, consolidation, air bronchogram, fever, cough, opacity', + 'Modality' => 3, + 'service_key' => 'X-RAY CHEST PA VIEW', + 'Findings' => <<TRACHEA & MEDIASTINUM : Trachea is central with no significant mediastinal shift. +CARDIAC SILHOUETTE : Cardiac size is within normal limits for age.
+LUNG PARENCHYMA : Patchy inhomogeneous airspace opacity with air bronchograms noted in the right mid and lower lung zones, suggestive of consolidation. The left lung field appears clear with normal bronchovascular markings.
+COSTOPHRENIC ANGLES : Mild blunting of the right costophrenic angle noted, likely reactive minimal pleural fluid. The left costophrenic angle is clear and sharp.
+DIAPHRAGMS : Right dome of diaphragm is partially obscured by the overlying lower lobe opacity. Left dome is smooth and normal in contour.
+BONES & SOFT TISSUES : Visualized thoracic skeleton and surrounding soft tissues are unremarkable.
+HTML + , + 'Impression' => "Features suggestive of Right Middle and Lower Lobe Pneumonia with minimal reactive pleural effusion.\nAdvice: Clinical correlation, sputum examination, and follow-up after antibiotic therapy.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'X-RAY BOTH KNEE JOINTS AP & LATERAL - Osteoarthritis', + 'title' => 'X-Ray Both Knee Joints AP and Lateral View', + 'keywords' => 'knee, osteoarthritis, joint space narrowing, osteophytes, pain, arthritis', + 'Modality' => 3, + 'service_key' => 'X-RAY BOTH KNEE JOINTS AP & LATERAL', + 'Findings' => <<JOINT SPACES : Narrowing of the medial tibiofemoral joint space noted bilaterally (Right > Left). Lateral tibiofemoral joint space is relatively preserved. +SUBCHONDRAL BONE : Subchondral sclerosis and flattening noted along the medial tibial plateau bilaterally.
+OSTEOPHYTES : Marginal osteophytes seen along the femoral and tibial condylar articular margins.
+PATELLOFEMORAL COMPARTMENT : Patellofemoral joint space shows mild narrowing with small patellar spurs.
+LIGAMENTS & SOFT TISSUES : Visualized soft tissues around the knee joint appear normal. No radiopaque loose body or chondrocalcinosis seen.
+BONE INTEGRITY : No fracture, dislocation, or lytic destructive bone lesion identified.
+HTML + , + 'Impression' => "Bilateral Knee Osteoarthritis with medial compartment predominance (Grade II-III Kellgren-Lawrence changes).\nAdvice: Clinical correlation and orthopedic consultation.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'X-RAY LS SPINE AP & LATERAL - Lumbar Spondylosis', + 'title' => 'X-Ray Lumbosacral (LS) Spine AP & Lateral View', + 'keywords' => 'spine, lumbar, ls spine, back pain, spondylosis, osteophytes, disc reduction', + 'Modality' => 3, + 'service_key' => 'X-RAY LS SPINE AP & LATERAL', + 'Findings' => <<ALIGNMENT & CURVATURE : Mild straightening of the normal lumbar lordosis noted, likely due to paravertebral muscle spasm. No spondylolisthesis or scoliosis seen. +VERTEBRAL BODIES : Vertebral body heights and bony architecture are maintained. Marginal osteophytic lipping noted along anterior and lateral borders of L3, L4, and L5 vertebrae.
+INTERVERTEBRAL DISC SPACES : Reduced intervertebral disc spaces noted at L4-L5 and L5-S1 levels with mild vacuum phenomenon / subchondral sclerosis.
+POSTERIOR ELEMENTS : Pedicles, laminae, and facet joints appear unremarkable. No lytic defect in pars interarticularis.
+SACROILIAC JOINTS : Both sacroiliac joints are clear with preserved joint spaces.
+PREVERTEBRAL TISSUES : Pre- and paravertebral soft tissue shadows are within normal limits.
+HTML + , + 'Impression' => "Features suggestive of Lumbar Spondylosis with L4-L5 and L5-S1 disc degenerative disease.\nAdvice: MRI Lumbosacral Spine recommended for radicular symptoms or neural canal evaluation.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'X-RAY CERVICAL SPINE AP & LATERAL (Normal / Spondylosis)', + 'title' => 'X-Ray Cervical Spine AP & Lateral View', + 'keywords' => 'cervical, neck pain, c-spine, spondylosis, radiculopathy, disc space', + 'Modality' => 3, + 'service_key' => 'X-RAY CERVICAL SPINE AP & LATERAL', + 'Findings' => <<ALIGNMENT : Normal cervical lordosis is mildly straightened (likely muscle spasm). Atlantoaxial alignment is normal. +VERTEBRAL BODIES : Vertebral body heights and densities are preserved. No bone destruction or compression fracture seen.
+DISC SPACES : Mild reduction of C5-C6 intervertebral disc space noted with small anterior marginal osteophytes. Remaining disc spaces are preserved.
+NEURAL FORAMINA & FACETS : Neural foramina and facet joints are within normal limits.
+SOFT TISSUES : Prevertebral soft tissue thickness is normal at all levels.
+HTML + , + 'Impression' => "Features suggestive of Mild Cervical Spondylosis at C5-C6 level with muscle spasm.\nAdvice: Clinical correlation.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'X-RAY ABDOMEN ERECT (Plain KUB / Acute Abdomen)', + 'title' => 'X-Ray Abdomen Erect (KUB)', + 'keywords' => 'abdomen erect, air fluid levels, gas, bowel obstruction, perforation, kub, calculus', + 'Modality' => 3, + 'service_key' => 'X-RAY ABDOMEN ERECT (KUB)', + 'Findings' => <<BOWEL GAS PATTERN : Normal bowel gas distribution seen throughout small and large intestines. No pathologically dilated bowel loops. +AIR-FLUID LEVELS : No step-ladder air-fluid levels seen to suggest dynamic intestinal obstruction.
+SUBDIAPHRAGMATIC AIR : No free air (crescent of gas) seen beneath either dome of the diaphragm (no pneumoperitoneum).
+URINARY TRACT (KUB) : No radiopaque shadow or calculus identified along the anatomical course of the kidneys, ureters, or bladder.
+PSOAS & FAT LINES : Bilateral psoas shadows and properitoneal fat lines are crisp and well preserved.
+SKELETON : Visualized lumbar spine, pelvis, and rib cage show no gross bony abnormality.
+HTML + , + 'Impression' => 'Normal Plain X-Ray Abdomen (Erect View). No evidence of bowel obstruction, perforation, or radiopaque calculus.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'X-RAY PNS WATER\'S VIEW - Sinusitis', + 'title' => 'X-Ray Paranasal Sinuses (PNS - Water\'s View)', + 'keywords' => 'pns, water view, sinuses, maxillary, headache, sinusitis, polyps', + 'Modality' => 3, + 'service_key' => 'X-RAY PNS (WATER\'S VIEW)', + 'Findings' => <<MAXILLARY SINUSES : Mucosal thickening and mucosal haziness noted in the bilateral maxillary antra (Right > Left). No distinct air-fluid level or polypoid mass seen. +FRONTAL & ETHMOID SINUSES : Frontal and ethmoidal sinuses appear normally pneumatized and aerated.
+NASAL SEPTUM & TURBINATES : Mild deviation of the nasal septum (DNS) noted towards the left with compensatory hypertrophy of the right inferior turbinate.
+BONY WALLS : Bony margins of all visualized paranasal sinuses are intact without cortical erosion.
+HTML + , + 'Impression' => "Features suggestive of Bilateral Maxillary Sinusitis (Right > Left) with Mild DNS.\nAdvice: ENT correlation.", + 'impression_cat' => 1, + ], + + // ================================================================= + // CT-SCAN TEMPLATES (Modality = 4) + // ================================================================= + [ + 'template_name' => 'NCCT HEAD / BRAIN (Normal)', + 'title' => 'Non-Contrast CT (NCCT) Head / Brain', + 'keywords' => 'ct head, brain, normal, stroke, trauma, headache, ncct, ventricles', + 'Modality' => 4, + 'service_key' => 'NCCT HEAD / BRAIN', + 'Findings' => <<TECHNIQUE : Non-contrast axial CT sections of the brain were obtained from the base of the skull to the vertex without intravenous contrast. +BRAIN PARENCHYMA : Both cerebral hemispheres, cerebellum, and brainstem show normal attenuation and preserved grey-white matter differentiation. No focal hypo- or hyperdense lesions noted. No evidence of acute intra-axial or extra-axial hemorrhage.
+VENTRICULAR SYSTEM : Lateral, third, and fourth ventricles are normal in size, shape, and position for age. No hydrocephalus.
+BASAL CISTERNS & SULCI : Basal cisterns, cortical sulci, and sylvian fissures are well visualized and symmetrical.
+MIDLINE STRUCTURES : Midline structures are central; no midline shift or herniation seen.
+SELLA & POSTERIOR FOSSA : Sella, parasellar regions, and cerebellopontine angles are unremarkable.
+CALVARIUM & ORBITS : Calvarial bones, skull base, orbits, and visualized paranasal sinuses show no fracture or gross pathology.
+HTML + , + 'Impression' => 'Normal Non-Contrast CT Scan of the Brain. No acute intracranial hemorrhage, mass lesion, or midline shift.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'NCCT HEAD - Acute Ischemic Infarct', + 'title' => 'NCCT Head - Acute Ischemic Infarct', + 'keywords' => 'ct head, infarct, ischemic stroke, mca, paralysis, weakness, hypodensity', + 'Modality' => 4, + 'service_key' => 'NCCT HEAD (STROKE PROTOCOL)', + 'Findings' => <<TECHNIQUE : Non-contrast volumetric CT of the brain performed under acute stroke protocol. +FOCAL LESION : Ill-defined, wedgeshaped area of parenchymal hypodensity noted involving the cortex and subcortical white matter of the left / right middle cerebral artery (MCA) territory.
+MASS EFFECT : Associated local sulcal effacement and mild loss of insular ribbon sign / grey-white differentiation noted. No significant midline shift or compression of lateral ventricle.
+HEMORRHAGE : No hyperdense area seen to suggest intracranial hemorrhage or hemorrhagic transformation.
+POSTERIOR FOSSA : Cerebellum, brainstem, and posterior fossa cisterns appear unremarkable.
+BONES & CISTERNS : Calvarial bones and visualized sinuses are intact.
+HTML + , + 'Impression' => "Features suggestive of Acute Non-Hemorrhagic Ischemic Infarct in the Left / Right MCA territory.\nAdvice: Urgent neurological evaluation, MRI Brain with DWI, and MR Angiography.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'HRCT CHEST / THORAX (Normal)', + 'title' => 'High Resolution Computed Tomography (HRCT) Thorax', + 'keywords' => 'hrct chest, thorax, lungs, covid, interstitial, fibrosis, ggo, bronchiectasis', + 'Modality' => 4, + 'service_key' => 'HRCT CHEST / THORAX', + 'Findings' => <<TECHNIQUE : High-resolution thin-section volumetric CT scan of the thorax was performed from lung apices to diaphragm during full inspiratory breath-hold. +AIRWAYS : Trachea and major bronchi are normal in caliber, course, and branching pattern. No endobronchial lesion or bronchiectasis seen.
+LUNG PARENCHYMA : Both lung fields show normal parenchymal attenuation. No evidence of ground-glass opacities (GGO), consolidation, nodule, mass, or cavitation. Interlobular septa and bronchovascular interstitium are unremarkable. No honeycombing or reticulation.
+PLEURAL SPACES : Bilateral pleural spaces are clear. No pneumothorax, pleural effusion, or thickening noted.
+MEDIASTINUM & HILA : Mediastinum and hilar structures are normal. No significant mediastinal, hilar, or axillary lymphadenopathy seen.
+CARDIOVASCULAR : Heart size, ascending/descending aorta, and pulmonary trunk are within normal limits.
+CHEST WALL & BONES : Visualized thoracic skeleton, sternum, ribs, and soft tissues of the chest wall appear normal.
+HTML + , + 'Impression' => 'Normal HRCT Thorax study. No active parenchymal infiltration, interstitial lung disease (ILD), or lymphadenopathy.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'CECT WHOLE ABDOMEN & PELVIS (Normal)', + 'title' => 'Contrast Enhanced CT (CECT) Whole Abdomen and Pelvis', + 'keywords' => 'cect abdomen, pelvis, liver, kidney, pancreas, spleen, contrast, ct abdomen', + 'Modality' => 4, + 'service_key' => 'CECT WHOLE ABDOMEN & PELVIS', + 'Findings' => <<TECHNIQUE : Contrast-enhanced helical CT of the whole abdomen and pelvis was acquired after administration of non-ionic IV contrast. +LIVER : Normal in size and shape with homogenous parenchymal enhancement. No focal intrahepatic mass, cyst, or abscess. Intrahepatic biliary radicles (IHBR) and common bile duct are normal.
+GALLBLADDER : Well distended with normal, uniform wall enhancement. No radiopaque calculus or pericholecystic collection seen.
+PANCREAS : Normal in size, lobulation, and enhancement throughout head, body, and tail. Main pancreatic duct is not dilated. Peripancreatic fat planes are preserved.
+SPLEEN : Normal in size, configuration, and enhancement. No focal lesion.
+ADRENALS & KIDNEYS : Bilateral adrenals are normal. Both kidneys are normal in size, shape, and position with prompt symmetrical nephrogram and excretion. Corticomedullary differentiation is preserved. No calculus, hydronephrosis, or mass.
+URINARY BLADDER & PELVIS : Urinary bladder is well distended with smooth walls. Internal pelvic organs are normal for age.
+GASTROINTESTINAL TRACT : Stomach and small/large bowel loops show normal caliber, wall thickness, and mucosal enhancement. No bowel obstruction.
+VESSELS & LYMPH NODES : Abdominal aorta, IVC, and portal vein are patent. No retroperitoneal, mesenteric, or pelvic lymphadenopathy. No ascites.
+HTML + , + 'Impression' => 'Normal Contrast-Enhanced CT (CECT) of Whole Abdomen and Pelvis. No focal pathology, organomegaly, or lymphadenopathy.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'NCCT KUB - Ureteric / Renal Calculus', + 'title' => 'Non-Contrast CT (NCCT) Kidneys, Ureters, and Bladder (KUB)', + 'keywords' => 'ncct kub, stone, calculus, kidney stone, ureteric stone, hydronephrosis, colic', + 'Modality' => 4, + 'service_key' => 'NCCT KUB (KIDNEYS, URETERS, BLADDER)', + 'Findings' => <<TECHNIQUE : Non-contrast helical CT scan of the abdomen and pelvis obtained from top of kidneys to pubic symphysis. +KIDNEYS : Both kidneys are normal in size, shape, and anatomical position. Right kidney measures ~... cm and left kidney measures ~... cm. No focal parenchymal mass lesion.
+CALCULUS & HYDRONEPHROSIS : A dense radiopaque calculus measuring approximately ... mm (CT density ~ ... HU) is noted in the proximal / mid / distal right / left ureter. Associated mild-to-moderate upstream hydroureter and hydronephrosis seen with mild perinephric fat stranding.
+CONTRALATERAL SYSTEM : Contralateral kidney and ureter are unremarkable without calculus or hydronephrosis.
+URINARY BLADDER : Moderately distended with uniform contents. No calculus or focal wall thickening seen at the vesicoureteric junctions.
+BONES & SOFT TISSUES : Visualized lumbosacral skeleton and pelvic bones appear unremarkable.
+HTML + , + 'Impression' => "Features suggestive of a ... mm Calculus in the Right / Left Ureter causing mild-to-moderate upstream hydronephrosis and hydroureter.\nAdvice: Urology consultation and management.", + 'impression_cat' => 1, + ], + + // ================================================================= + // MRI TEMPLATES (Modality = 2) + // ================================================================= + [ + 'template_name' => 'MRI BRAIN (PLAIN STUDY - Normal)', + 'title' => 'MRI Brain (Plain Study)', + 'keywords' => 'mri brain, normal, head, t1, t2, flair, dwi, stroke, seizure, headache', + 'Modality' => 2, + 'service_key' => 'MRI BRAIN (PLAIN STUDY)', + 'Findings' => <<TECHNIQUE : Multiplanar, multisequence MRI of the brain was performed on high-field system using T1WI, T2WI, FLAIR, Diffusion Weighted Imaging (DWI/ADC), and Gradient Echo (GRE/SWI) sequences. +CEREBRAL PARENCHYMA : Both cerebral hemispheres show normal sulcation, gyration, and grey-white matter differentiation. No focal area of altered signal intensity noted in the cerebral cortex, subcortical white matter, or deep grey nuclei.
+DIFFUSION & HEMORRHAGE : No area of restricted diffusion on DWI/ADC to suggest acute ischemic infarction or cytotoxic edema. No blooming artifact on GRE/SWI sequences to suggest acute or chronic intracranial hemorrhage.
+BRAINSTEM & CEREBELLUM : Brainstem (midbrain, pons, medulla) and both cerebellar hemispheres appear normal in morphology and signal characteristics.
+VENTRICLES & CISTERNS : Ventricular system, basal cisterns, and sylvian fissures are normal in size, shape, and configuration for age. Midline structures are central.
+SELLA & CRANIAL NERVES : Sella, pituitary gland, optic chiasm, and bilateral CP angles are within normal limits.
+CALVARIUM & SINUSES : Visualized calvarial marrow and paranasal sinuses show normal signal intensity.
+HTML + , + 'Impression' => 'Normal MRI Brain Study. No evidence of acute ischemia, hemorrhage, mass effect, or demyelinating lesion.', + 'impression_cat' => 0, + ], + [ + 'template_name' => 'MRI LUMBOSACRAL (LS) SPINE - Disc Herniation / Sciatica', + 'title' => 'MRI Lumbosacral (LS) Spine', + 'keywords' => 'mri spine, ls spine, lumbar, disc bulge, herniation, sciatica, radiculopathy, stenosis', + 'Modality' => 2, + 'service_key' => 'MRI LUMBOSACRAL (LS) SPINE', + 'Findings' => <<TECHNIQUE : Multiplanar MRI of the lumbosacral spine performed in T1W, T2W, and STIR sagittal and axial sequences. +CURVATURE & ALIGNMENT : Mild straightening of the normal lumbar lordosis noted, consistent with paravertebral muscle spasm. Vertebral body alignment is preserved without listhesis.
+VERTEBRAL BODIES : Vertebral body heights are maintained. No acute compression fracture, bone marrow edema, or focal marrow infiltration seen on STIR.
+L4-L5 LEVEL : Shows diffuse disc bulge with a central/paracentral posterior disc protrusion compromising the anterior epidural space and indenting the thecal sac. Mild narrowing of bilateral neural foramina with abutment of traversing L5 nerve roots.
+L5-S1 LEVEL : Shows mild diffuse posterior disc bulge with preserved neural exit foramina and no significant canal compromise.
+OTHER DISC LEVELS : L1-L2, L2-L3, and L3-L4 intervertebral disc spaces and disc hydration are well preserved.
+SPINAL CORD & CAUDA EQUINA : Conus medullaris ends normally at the L1-L2 level with normal signal intensity. Cauda equina nerve roots are normal in distribution.
+PARASPINAL TISSUES : Visualized facet joints, posterior elements, and paraspinal soft tissues are unremarkable.
+HTML + , + 'Impression' => "Features suggestive of L4-L5 Central/Paracentral Disc Protrusion causing thecal sac indentation and bilateral neural foraminal narrowing with nerve root abutment. Associated Lumbar Spondylodisco-degenerative changes.\nAdvice: Clinical and neurological correlation.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'MRI CERVICAL SPINE - Cervical Spondylosis', + 'title' => 'MRI Cervical Spine', + 'keywords' => 'mri c-spine, cervical, neck pain, disc protrusion, myelopathy, cord compression', + 'Modality' => 2, + 'service_key' => 'MRI CERVICAL SPINE', + 'Findings' => <<TECHNIQUE : Multiplanar MRI of the cervical spine acquired in sagittal T1WI, T2WI, STIR, and axial T2WI sequences. +ALIGNMENT : Straightening of normal cervical lordosis noted, suggestive of muscle spasm. Craniocervical junction is normal.
+VERTEBRAE & MARROW : Vertebral body heights and alignment are maintained. No evidence of fracture or marrow replacing lesion.
+C5-C6 LEVEL : Shows posterior disc-osteophyte complex with left paracentral disc herniation indenting the anterior thecal sac and narrowing the left neural foramen with abutment of exiting left C6 nerve root.
+C6-C7 LEVEL : Shows mild diffuse disc bulge without significant thecal sac indentation.
+CERVICAL CORD : Cervical spinal cord is normal in caliber throughout its course with uniform signal intensity. No focal T2/STIR hyperintensity to suggest compressive myelopathy, syrinx, or demyelination.
+SOFT TISSUES : Prevertebral and posterior paraspinal soft tissues are normal.
+HTML + , + 'Impression' => "Features suggestive of Cervical Spondylosis with C5-C6 Posterior Disc Herniation causing left neural foraminal narrowing and root impingement.\nNo compressive cervical myelopathy.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'MRI KNEE JOINT - Meniscal & Ligament Assessment', + 'title' => 'MRI Knee Joint (Right / Left)', + 'keywords' => 'mri knee, acl, pcl, meniscus, tear, knee pain, effusion, cartilage, ligament', + 'Modality' => 2, + 'service_key' => 'MRI KNEE JOINT (RIGHT / LEFT)', + 'Findings' => <<TECHNIQUE : Multiplanar MRI of the knee joint was performed using PD, PD-FS, T1WI, and T2-GRE sequences in coronal, sagittal, and axial planes. +MEDIAL MENISCUS : Grade II intrameniscal linear hyperintensity seen in the posterior horn of the medial meniscus, not extending to the superior or inferior articular surfaces (suggestive of intrasubstance degeneration without tear).
+LATERAL MENISCUS : Anterior and posterior horns of the lateral meniscus show normal triangular morphology and uniform low signal intensity. No tear seen.
+CRUCIATE LIGAMENTS : Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) show normal course, thickness, and signal intensity. Fibers are continuous and intact.
+COLLATERAL LIGAMENTS : Medial Collateral Ligament (MCL) and Lateral Collateral Ligament complex (LCL) are intact with normal appearances.
+EXTENSOR MECHANISM : Quadriceps tendon and patellar tendon show normal signal intensity. Patellofemoral cartilage is preserved.
+JOINT EFFUSION & BONE MARROW : Mild joint effusion noted in the suprapatellar pouch. No subchondral bone marrow edema or osteochondral defect noted in femoral condyles or tibial plateau.
+HTML + , + 'Impression' => "Grade II Degenerative Signal Change in the Posterior Horn of the Medial Meniscus.\nMild knee joint effusion. Intact ACL, PCL, and collateral ligaments.", + 'impression_cat' => 1, + ], + [ + 'template_name' => 'MRI WHOLE SPINE SCREENING (Normal)', + 'title' => 'MRI Whole Spine Screening', + 'keywords' => 'mri whole spine, screening, metastasis, cord, sagittal t2, stir, normal spine', + 'Modality' => 2, + 'service_key' => 'MRI WHOLE SPINE SCREENING', + 'Findings' => <<TECHNIQUE : Sagittal T2WI and STIR screening images of the entire spine from craniocervical junction to coccyx. +CURVATURE & ALIGNMENT : Normal cervical, thoracic, and lumbar spinal curvatures and vertebral alignment are preserved.
+VERTEBRAL BODIES : Vertebral body heights and marrow signal intensities are normal across all levels. No focal bone destruction, collapse, or STIR marrow hyperintensity to suggest metastasis or trauma.
+DISC SPACES : Intervertebral disc heights and signals are generally preserved with early mild degenerative disc dehydration at L4-L5 and L5-S1 levels. No gross disc herniation or spinal canal stenosis.
+SPINAL CORD : Spinal cord shows normal caliber and signal intensity throughout cervical and thoracic regions. Conus medullaris terminates normally at L1 level.
+PARASPINAL TISSUES : Pre- and paravertebral soft tissues are unremarkable.
+HTML + , + 'Impression' => 'Normal MRI Whole Spine Screening study. No focal marrow infiltrative lesion, vertebral collapse, or spinal cord compression.', + 'impression_cat' => 0, + ], + ]; + + // --------------------------------------------------------------------- + // 3. Upsert Templates into `radiology_ultrasound_template` + // --------------------------------------------------------------------- + $insertedCount = 0; + $updatedCount = 0; + + foreach ($templates as $tpl) { + $chargeId = 0; + if (! empty($tpl['service_key']) && isset($chargeIdMap[$tpl['service_key']])) { + $chargeId = $chargeIdMap[$tpl['service_key']]; + } + + $existing = $db->table('radiology_ultrasound_template') + ->where('template_name', $tpl['template_name']) + ->where('Modality', $tpl['Modality']) + ->get(1) + ->getRowArray(); + + $data = [ + 'template_name' => $tpl['template_name'], + 'title' => $tpl['title'], + 'keywords' => $tpl['keywords'], + 'Modality' => $tpl['Modality'], + 'charge_id' => $chargeId, + 'Findings' => $tpl['Findings'], + 'Impression' => $tpl['Impression'], + 'impression_cat' => $tpl['impression_cat'], + ]; + + if (! empty($existing['id'])) { + $db->table('radiology_ultrasound_template') + ->where('id', $existing['id']) + ->update($data); + $updatedCount++; + } else { + $db->table('radiology_ultrasound_template')->insert($data); + $insertedCount++; + } + } + + CLI::write("Radiology Templates Seeding Complete!", 'green'); + CLI::write(" - Charge Services Verified/Added: " . count($chargeIdMap)); + CLI::write(" - Templates Inserted: {$insertedCount}"); + CLI::write(" - Templates Updated: {$updatedCount}"); + CLI::write(" - Total Templates: " . (count($templates))); + } +}