249 receiving multiple MRI’s, the MRI performed closest to IVF/ICSI treatment was chosen for measurements. Full details can be found in Appendix 10A. MRI measurements The MRI features assessed with a brief definition, unit, calculation and stratification can be found in Table 10.1, and an illustration of measurements taken shown in Figure 10.1. Measurements were performed independently by two study investigators (CR and SK) using Sectra IDS7 version 21.1 (Linköping, Sweden). The investigators’ measurements were subsequently compared and measurements were considered equal when there was a difference ≤ 1 mm. A pelvic radiologist was consulted when doubts presented about the performed measurements. For all measurements, the junctional zone was defined as a low signal intensity region between the high signal intensity region of the endometrium and the intermediate signal intensity region of the outer myometrium on T2. In case of an ill-defined junctional zone which inhibited accurate measurement, the MRI was labelled as having ‘poor JZ definition’. Focal adenomyosis was defined as focal widening of the JZ, or an ill-defined low signal intensity region of the uterine wall. In order to avoid mistaking uterine contractions for focal lesions, the precise location of the low signal intensity region was assessed in three directions (using a localisation cursor). When this low intensity region was not seen in other directions, it was categorised as a uterine contraction. Diffuse adenomyosis was defined in case of a diffuse thickening of the JZ of ≥ 12 mm showing a low T2 signal intensity with indistinct margins (Figure 10.1C).
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