Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A new endotracheal tube is in satisfactory position approximately 4 .5 cm from the carina . The nasogastric tube courses below the diaphragm with the tip out of fields of view . Since the prior exam , the lung volumes are lower . There is moderate pulmonary edema , which is somewhat accentuated by the lower lung volumes , though likely worsened . Small pleural effusions are difficult to exclude . There is no pneumothorax . Mediastinal contours appears wider , which may be due to technique . The heart size remains mildly enlarged .
    OUTPUT:
    
1 . Slight interval worsening of the moderate pulmonary edema . 2 . Minimally widened mediastinum , likely accounted for by supine technique . There is high clinical concern for dissection , could consider a CT . 3 . Satisfactory position of the endotracheal and nasogastric tubes .