56 Figure 2.7: Diagnostic Performance of Junctional Zone Differential > 5mm on MRI vs. Histopathology Junctional Zone to Myometrium Ratio / Extent of Myometrial Involvement In order to quantify the extent of the invasion adenomyosis on MRI, several studies have investigated the (maximal) ratio of JZ to normal myometrium of the uterus (n=16 studies, see Table 2.1). This is thought to signify a relative increase in JZ thickness, and thereby myometrial tissue involvement. It is expressed as a percentage or ratio, with a value of 40-50% generally thought to indicate adenomyosis (see Figure 2.8 for an example). Two studies investigated the diagnostic performance of this parameter (see Table 2.2, Figure 2.9 and supplementary file Figures 2.S5 and 2.S6 for details).
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