Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . Enlargement of the left and main pulmonary arteries is again noted , not significantly changed from the prior studies . The right hilar contour is within normal limits . Emphysema is again seen , most pronounced within the lung apices . Minimal streaky opacity in the left lung base is similar and may reflect minimal atelectasis . No focal consolidation , pleural effusion or pneumothorax is present . There are no acute osseous abnormalities . Cholecystectomy clips are noted in the right upper quadrant of the abdomen .
    OUTPUT:
    
No radiographic evidence for pneumonia . Emphysema . Enlargement of the main and left pulmonary arteries , unchanged , for which correlation with echocardiography , if not previously done , is suggested .