title: The Significance of MRI Evaluation of the Uterine Junctional Zone in the Early Diagnosis of Adenomyosis.
abstract: OBJECTIVE
  The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in women with adenomyosis compared to those without it, given the importance of the JZ in the regulation of various reproductive events.
  
  
  METHODS
  This was a prospective, comparative and open study. Patients with adenomyosis have been sorted in target group, n = 82, while the control group consisted of patients without adenomyosis, n = 82. All patients, from both groups have undergone a magnetic resonance imaging of the pelvis. Using a software tool for measurement, the thickness of the JZ was measured in T2w sag sequences in all patients from both groups (target and control) n = 164. Patients in the target group type adenomyosis were assessed and categorized either as: diffuse, focal, or Adenomyoma and the results were compared. The presence of endometriosis and myomas in both groups was evaluated and its coexistence with adenomyosis was analyzed as well.
  
  
  RESULTS
  Of the 82 patients in the target group, 81.7% of the patients had diffuse adenomyosis, while 18.3% had focal type with statistically significant difference (p <0.05). The results of the Mann-Whitney U test showed that p <0.05, implying that there is a statistically significant difference in the thickness of the JZ between the control and target group, therefore patients from the target group with adenomyosis had a statistically significantly thicker junctional zone than the patients in the control group. The JZ in the target group was on average M = 14,3mm, SD = 1.3mm, while the thickness of JZ in the control group without adenomyosis was M = 5,6mm, SD = 1,3. Chi-square shows that p <0.05, implying that there is a statistically significant difference in the number of patients with myomas between the two groups, where the myomas significantly over-represented in the target group with 32,9 % vs.6 %).
  
  
  CONCLUSIONS
  MRI is the method of choice for imaging and evaluation of JZ as an important diagnostic marker in the diagnosis of adenomyosis. It is important to recognize this condition as early as possible and distinguish it from other pathologies in order for timely and appropriate treatment.
authors.affiliation: Clinic of Radiology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Amela
authors.initials: A
authors.lastname: Sofic
authors.affiliation: Institute of Gastroenterology and Hepatology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Azra
authors.initials: A
authors.lastname: Husic-Selimovic
authors.affiliation: Clinic of Radiology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Aladin
authors.initials: A
authors.lastname: Carovac
authors.affiliation: Clinic of Radiology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Elma
authors.initials: E
authors.lastname: Jahic
authors.affiliation: Clinic of Oncology and Radiotherapy University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Velda
authors.initials: V
authors.lastname: Smailbegovic
authors.affiliation: Institute of Gastroenterology and Hepatology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Jana
authors.initials: J
authors.lastname: Kupusovic
keywords: Adenomyosis; Junctional zone; MRI