55 Figure 2.5: Diagnostic Performance of Junctional Zone > 12mm on MRI vs. Histopathology Junctional Zone Differential / Junctional Zone Irregularity Another frequently (n=7 studies) reported quantifiable measure of adenomyosis on MRI is the JZ differential (JZ Diff). This is calculated by subtracting the JZ Min from the JZ Max, and functions as an objective measure of the irregularity of the uterine JZ, which can be a diagnostic criterion for adenomyosis (see Figure 2.6 for an example). Two studies (45,122) investigated its diagnostic performance (see Table 2.2, Figure 2.7, Figure 2.S3 and 2.S4 for details). JZ asymmetry, measured as the difference between the anterior and posterior JZ at the same point of the uterus was only mentioned in one study (137). Figure. 2.6: Sagittal T2W MRI showing junctional zone (JZ) asymmetry of the anterior and posterior walls, with a JZ differential (JZ Diff) > 5mm
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