Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: When compared with prior , there has been no significant interval change . Bilateral upper lobe scarring with retraction of the hila is noted . Small bilateral effusions have not significantly changed . There is no new consolidation . Cardiac silhouette is enlarged but similar in configuration . Old left - sided rib fractures are again noted . No acute osseous abnormalities detected .
    OUTPUT:
    
No acute cardiopulmonary process . Persistent small bilateral effusions .