101 MRI characteristics MRI characteristics of the external dataset are summarised in Table 4.2. In 38 patients, it was not possible to assess the MRI features, as the researchers were unable to identify the junctional zone or the endometrium. The main reason for this was the presence of uterine fibroids, which distorted the uterine anatomy. Among the included patients, statistically significant differences were found between patients with adenomyosis versus without for mean JZ thickness (10.434 mm ±4.21 vs. 7.805mm ±2.18), maximal JZ thickness (17.765mm ± 8.57 vs. 11.553mm ±3.49), JZ differential (11.980 mm ±8.30 vs. 6.753mm ± 2.99) and mean JZ/MYO ratio (0.533 ±0.10 vs. 0.461 ± 0.11), all p <0.001. Patients with adenomyosis also more often had values above the cut-offs of maximal JZ ³ 12 mm, JZ differential ³ 5mm, JZ/MYO ratio >0.40, and the presence of HSI foci (all p <0.001 for each of these variables). An example of the assessment of the MRI features is shown in Figure 4.3. Figure 4.3. Examples of the measurements of the MRI features. Left: a patient without the histopathological diagnosis of adenomyosis. The mean JZ was 7.3. JZ differential was 4.4, so <5mm. JZ/MYO ratio was 0.47, so >0.40. And no HSI foci were observed. Right: MRI measurements from the MRI of a patient with the histopathological diagnosis of adenomyosis. Mean JZ was 14.1. JZ differential was 23.4 (>5mm). JZ/MYO ratio was 0.60 (>0.40) and HSI foci were observed (white arrow shows a foci).
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