Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lung volumes are exceedingly low , resulting in crowding of the bronchovascular structures and accentuation of the mediastinal silhouette . The heart size is normal but increased from the prior study . Leftward deviation of the trachea from the inominate artery is better seen on the prior CTA . Dense calcification is seen within the aortic arch . There is no pleural effusion , pneumothorax or focal airspace consolidation . A dextroscoliosis of the thoracic spine is unchanged . Old right rib fractures are again seen without an acute fracture .
    OUTPUT:
    
Low lung volumes limiting full evaluation . No acute fracture .