OP07.07: MUSA‐classification of junctional zone appearance in MRI shows a good diagnostic prediction of adenomyosis, while junctional zone measurement does not

To assess the diagnostic accuracy of a junctional zone (JZ) thickness of ≥ 12 mm and morphological features of the JZ in magnetic resonance imaging (MRI) in diagnosing adenomyosis in a premenopausal study population. This single-centre, prospective observational study enrolled consecutively 93 premenopausal women suffering from a benign gynecological condition, from September 2014 to August 2016. Institutional review board approval and written consent from the participants were obtained. All participants underwent MRI and hysterectomy with a histopathological examination. MR images were evaluated in a blinded fashion by two independent readers. The maximum junctional zone thickness (JZmax) and presence of JZmax ≥ 12 mm were documented. The appearance of the JZ was further evaluated using a modified version of the classification proposed by the Morphological Uterus Sonographic Assessment (MUSA) group. Any irregular appearance of the JZ (defined as irregular outer or inner borders, focal thickening, presence of high-intensity signal foci or fingerlike indentations at the inner border) was documented, and the diagnostic performance was calculated. Adenomyosis was histopathologically confirmed in 57 (61%) of the women. JZmax was not positively correlated with adenomyosis diagnosis (AUC = 0.57, P = 0.26) and did not differ significantly between those with and without adenomyosis (10.3 vs. 10.1 mm, P = 0.88), nor was a cutoff of JZmax ≥ 12 mm [n = 30/57 (53%) vs. n = 16/36 (44%), P = .29]. However, the presence of an irregular JZ was strongly associated with adenomyosis [sensitivity 74% (95% CI: 60, 85); specificity 83% (95% CI: 67, 94) (P < 0.001)]. JZmax was not correlated with adenomyosis in the present study population, but the irregular appearance of the JZ provided a good diagnostic accuracy. An ultrasonographic classification was helpful to assess adenomyosis also in MRI. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.