59 Figure 2.11: Sagittal T2W MRI showing an enlarged, diffusely adenomyotic uterus, with a uterine length (UL) of 16.2cm and a uterine width (UW) of 10.5cm Only uterine enlargement was investigated for diagnostic accuracy, see Table 2.2, Figure 2.12, and Figures 2.S7 and 2.S8 for details). Figure 2.12: Diagnostic Performance of Uterine Enlargement on MRI vs. Histopathology Uterine wall thickness (either as a mean, or the maximum thickness) has also been reported, with 12 studies reporting this as an outcome measure (Table 2.1). Most studies assessed this parameter in the context of high frequency ablation treatment. The shape of the uterus is an additional feature of adenomyosis that has been evaluated. Several studies reported homogenous or smooth enlargement of the uterus as a defining characteristic of adenomyosis, and others looked at uterine asymmetry (as in Figure 2.13). Most studies evaluated this subjectively, but four studies (8,113,137,149) quantified the extent of uterine asymmetry by measuring the difference between the width of the anterior and posterior walls in the context of adenomyosis.
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