96 from the patient files: age at MRI and hysterectomy, BMI at MRI, history of curettage, other gynaecological or uterine pathology, treatment and clinical symptoms such as dysmenorrhea and hypermenorrhea. The following primary MRI parameters were investigated: Mean Junctional Zone (JZ) thickness, JZ Differential, JZ/MYO ratio and myometrial high signal intensity (HSI) foci. Figure 4.1 shows an illustrative example of the measuring points of the Junctional Zone (JZ). The exact definition and stratification of all measured MRI parameters are provided in Appendix B. The diagnosis of adenomyosis was considered if any of the following factors were present: presence of HSI foci, asymmetric enlarged uterus (other than due to the existence of leiomyomas) or JZ thickness greater than 12mm. The MRI parameters were measured with the use of Synapse® Mobility version 5.7 (FUJIFILM Medical Systems U.S.A). Data management The study utilised Research Manager (Research Manager, Deventer, the Netherlands), a secure software program, to securely store patient Junctional Zone (JZ) Figure 4.1. MRI of a patient in this external dataset without a histopathological diagnosis of adenomyosis. The Junctional Zone (JZ), the interface between the inner myometrium and the endometrium, was measured in six points of the uterus: fundus, mid-corpus, isthmus, measuring the anterior and posterior wall at each point. MP IP FP FA MA IA
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