Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild cardiomegaly is re- demonstrated . Mediastinal contours are unchanged with atherosclerotic calcifications noted at the aortic knob . Hilar contours are similar . Lungs are hyperinflated with patchy bibasilar airspace opacities noted , worse since the previous study . A small left pleural effusion is not excluded . No pulmonary edema is seen . There is biapical pleural scarring . Multilevel degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
Worsening bibasilar airspace opacities which may reflect increased atelectasis though aspiration or infection are not excluded . A small left pleural effusion may be present .