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Some sections include some optional infos as the author, the informant, the subject,...; some few of them ; other none .Clarify if there is a reason for having such differences and in case harmonize the sections (agreeing what should be in and what should be out)
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-Decision:
The LOINC code used here 12132-7 is US Study observation general [Interpretation] Narrative, an Ultrasound Study Code.
Use another one, suggestion: 47045-0 Study report, which may carry the general nature of the result section here, or 30954-2 Relevant diagnostic tests/laboratory data Narrative that is also used elsewhere
Section/text is 0..1 M. Elements cannot logically be both optional and mandatory.
If you want to avoid @nullFlavor, you should add that attribute as prohibited. In any case you should switch to 0..1 R or 1..1 M