Reason: mass under the inferior border of both scapular History: mass under the inferior border of both scapulae. There are crescentic masses deep to both scapular tips between the serratus anterior and the underlying rib cage. The masses are predominantly isointense to muscle but contain small foci of high signal intensity on T1 weighted images compatible with fatty elements, are slightly hyperintense to skeletal muscle on fluid sensitive sequences, and show enhancement following gadolinium administration. The location, morphology, and signal characteristics are compatible with elastofibromas. The right mass measures approximately 7 x 2 cm in the transverse dimension and approximately 8 cm in the craniocaudal dimension. The left mass measures approximately 6.5 cm x 1.5 cm in the transverse dimension and 8 cm in the craniocaudal dimension. There is a lesion within segment 8 of the liver which demonstrates increased signal intensity on T1 and STIR sequences and shows mild peripheral enhancement on postcontrast sequences. This is nonspecific and incompletely characterized/imaged on this examination. After consult with the abdominal imaging section, a triple phase MRI of the liver is recommended for further evaluation. Moderate degenerative disc disease is identified throughout the visualized cervical and thoracic spine. There are fluid collections along the anterior aspect of the subscapularis muscles, bilaterally, that we suspect represent bilateral subcoracoid bursitis. There also appears to be osteoarthritis of the acromioclavicular joints as well as a full-thickness rotator cuff tear on the right.
1. Bilateral elastofibromas as described above. 2. Incompletely characterized segment 8 liver lesion for which further evaluation with a dedicated triple phase MRI examination of the liver is recommended.3. Other findings as described above.