The main strengths of our study include the homogenous subset of infertile/subfertile patients who were all evaluated with MRI scans on a 3 T system based on an index of suspicion for adenomyosis raised on either transabdominal and transvaginal USG. All MRI scans were performed using standardized protocols and the same operator reviewed and reported the images using a standardized reporting template, thus obviating interobserver variation. The main limitation included the absence of histologic confirmation of adenomyosis; however, it is accepted that noninvasive imaging tools such as USG and MRI have reached a very high level of accuracy and concordance with histologic findings, hence obviating the need for histopathological confirmation. This was a retrospective study on a small subset of infertile patients who presented to the IVF clinical unit with a suspicion of adenomyosis on USG. MRI was not performed in every patient who presented to the infertility clinic and was limited only to a subset of patients in whom a pelvic pathology was suspected, and, hence may have led to overestimation of the prevalence of adenomyosis in the overall infertile patient population. In conclusion, our retrospective study, demonstrates the ability of high-resolution MRI at 3 T to detect the subtle nuances of adenomyosis, and, its relationship with pelvic endometriosis.
The authors declare that they have no financial conflict of interest with regard to the content of this report.
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