102 Table 4.2 MRI characteristics. Histopathology: Adenomyosis (n=78) Histopathology: No adenomyosis (n=117) P-value Mean JZ (mm) 10.434 ± 4.21 7.805 ± 2.18 <0.001 JZ Max (mm) 17.765 ± 8.57 11.553 ± 3.49 <0.001 JZ Diff (mm) 11.980 ± 8.30 6.753 ± 2.99 <0.001 Mean JZ/MYO 0.533 ± 0.10 0.461 ± 0.11 <0.001 Mean JZ Asymmetry 1.290 ± 5.81 0.676 ± 1.37 0.314 Mean Wall Thickness (mm) 21.066 ± 8.87 19.448 ± 7.24 0.078 Mean Wall Asymmetry (mm) 8.563 ± 25.56 1.9352 ± 38.99 0.233 Mean Uterine Length (mm) 99.761 ± 28.30 99.680 ± 27.52 0.804 Mean Uterine Volume (mm3) 304473.4 mm3 ± 317462.1 331939.1 ± 533134.7 0.807 Adenomyosis Focus SI 33.168 ± 27.13 19.947 ± 8.71 0.071 SI Ratio 1.9366 ± 0.87 1.809 ± 0.55 0.912 JZ Max ³12 mm 61 (78.2%) 35 (29.9%) <0.001 JZ Diff ³5 mm 72 (92.3%) 67 (57.3%) <0.001 JZ/MYO >.4 60 (76.9%) 58 (49.6%) <0.001 HSI Foci 55 (70.5%) 6 (5.1%) <0.001 MRI = Magnetic Resonance Imaging; JZ = Junctional Zone; JZ Max = Junctional Zone Maximum; JZ Diff = Junctional Zone Differential; JZ/MYO ratio = Junctional Zone to Myometrium Ratio; SI = Signal Intensity; HSI = High Signal Intensity; Diagnostic accuracy The diagnostic accuracy of various potential predictors of adenomyosis and MRI in general for the external validation group is summarized in Table 4.3. These measurements were done to compare these values of the potential predictors from both datasets. Radiology reports of MRI overall in this population had a sensitivity of 21.8%, a specificity of 91,5%, a PPV of 63.0%, a NPV of 63.7%, a positive LR of 2.6 and a negative LR of 0.9. The overall accuracy of MRI was 63.6%. The MRI feature with the best overall accuracy was presence of HSI foci (84.7%). HSI foci had a sensitivity of 70.5%, a specificity of 89.7%, a PPV of 90.2%, a NPV of 82.0%, a positive LR of 6.8 and a negative LR of 0.3.
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