Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size remains moderate to severely enlarged . The mediastinal contours remain widened , due to mediastinal lipomatosis . There is mild pulmonary vascular engorgement , similar compared to the previous exam , and a probable small right pleural effusion . No pneumothorax is identified . Bibasilar airspace opacities likely reflect atelectasis . There are multilevel degenerative changes in the imaged thoracic spine .
    OUTPUT:
    
Mild pulmonary vascular engorgement and small right pleural effusion . Bibasilar airspace opacities likely reflect atelectasis but infection or aspiration can not be completely excluded .