Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with ___ at 18 : 23 , I doubt significant change . Again seen are low inspiratory volumes , sternal wires and prominence of the cardiomediastinal silhouette , and left lower lobe collapse and / or consolidation . There is upper zone redistribution , likely accentuated by low inspiratory volumes , without overt CHF . Although small right and left effusions can not be excluded , no gross effusion is identified . As before , a right IJ central line is again seen , with tip over distal SVC .
    OUTPUT:
    
Doubt significant change compared with ___ at 18 :23