Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild enlargement of cardiac silhouette is re - demonstrated . The mediastinal and hilar contours are unchanged . There is worsening interstitial pulmonary edema compared to the previous exam , now mild to moderate in extent , with probable tiny bilateral pleural effusions which are unchanged . Lungs remain hyperinflated with flattening of the diaphragms suggestive of COPD . No pneumothorax is identified . Spinal fusion hardware within the thoracolumbar junction is re - demonstrated .
    OUTPUT:
    
Interval worsening of mild to moderate interstitial pulmonary edema with probable unchanged trace bilateral pleural effusions . As noted previously , follow up radiographs after diuresis are recommended to assess for an underlying interstitial lung disease .