Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The left lung remains mostly clear but again shows several nodules which are not clearly changed although difficult to compare directly for small possible size changes using radiography . The right hemidiaphragm is again elevated with pleural thickening and right apical paramediastinal consolidation with dilated airways , often seen after radiation therapy . This appearance includes an unchanged small collection of air and fluid at the right lung apex . The only clear change is somewhat decreased aeration of the residual right lung which may be due to unilateral edema , lymphatic congestion or possibly an increased pleural effusion . A dilated segment of small bowel is visualized in the epigastric region measuring up to 4 cm in diameter . The patient is status post posterior thoracic spinal fusion with no clear change .
    OUTPUT:
    
Somewhat decreased aeration of the residual right lung but otherwise no significant change since earlier studies . Dilatation of small bowel in the epigastrium which is non-specific , not necessarily significant clinically , although correlation with clinical findings is recommended .