Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are far lower compared to ___ causing vascular crowding and accentuate the size of the aortic arch ; however , the mediastinal silhouette appears rather significantly increased compared to prior exam , but this still may be due to low lung volumes . Otherwise , there is no significant change in moderate - to - large left pleural effusion with associated atelectatic change despite placement of a left base chest tube . There is no pneumothorax .
    OUTPUT:
    
Unchanged moderate - to - large left pleural effusion despite chest tube placement . Significant increase in size of the aortic shadow which may be due to low lung volumes , however , a repeat study with full inspiration is recommended to evaluate the aortic contour .