Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are new bilateral small pleural effusions with adjacent atelectasis . Additionally , the cardiac silhouette appears significantly enlarged in comparison to the prior study . Otherwise , the remainder of the lungs are clear . Moderate degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
1 . Significant enlargement of the cardiac silhouette in comparison to the prior study . Although this may be positional in nature , a pericardial effusion can not be excluded . 2 . New small bilateral pleural effusions with adjacent atelectasis .