Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: COMPARED WITH ___ AT 409 AND ALLOWING FOR TECHNICAL DIFFERENCES , NO GROSS CHANGE IS IDENTIFIED . AGAIN SEEN IS THE TRACHEOSTOMY TUBE , RIGHT IJ CENTRAL LINE AND PICC LINE , SIMILAR IN CONFIGURATION . THE PICC LINE TIP IS OBSCURED , BUT MOST LIKELY OVERLIES THE PROXIMAL / MID SVC . NO PNEUMOTHORAX IS DETECTED . THE CARDIOMEDIASTINAL SILHOUETTE IS UNCHANGED . BILATERAL EFFUSIONS WITH UNDERLYING COLLAPSE AND / OR CONSOLIDATION AGAIN SEEN . THERE IS SUGGESTION OF UPPER ZONE REDISTRIBUTION AND VASCULAR BLURRING CONSISTENT WITH CHF . POSSIBILITY OF UNDERLYING INFECTIOUS INFILTRATE WOULD BE DIFFICULT TO EXCLUDE .
    OUTPUT:
    
DOUBT SIGNIFICANT CHANGE COMPARED WITH ___