Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are lower compared to the previous study . Cardiac silhouette size is normal . The mediastinal and hilar contours are unchanged . Severe emphysema is re - demonstrated . There is probable mild pulmonary vascular congestion . Patchy opacities are again noted in both lung bases , minimally improved compared to the previous radiograph . No new areas of focal consolidation or clearly identified . No pleural effusion or pneumothorax is seen . Scarring within the lung apices is symmetric . There are no acute osseous abnormalities identified . Several clips are noted within the upper abdomen .
    OUTPUT:
    
Persistent patchy opacities in the lung bases , minimally improved in the interval , and remain concerning for pneumonia . Probable mild pulmonary vascular congestion .