Abstract: Objective：To explore the diagnostic value of combined junctional zone thickness indices and intralesional T2hyperintense foci in magnetic resonance imaging (MRI) in the diagnosis of adenomyosis. Methods：MRI data of 56 patients with adenomyosis confirmed by surgery and pathology and 35 cases in the control group were retrospectively analyzed. On the basis of observing the characteristics of MRI lesions of adenomyosis, the maximum junctional zone thickness (JZmax), the junctional zone difference between the maximum and the minimum (JZdif), and the thickness ratio of junctional zone to myometrium (JZrat) were measured. JZmax, JZdif, and JZrat were compared between the two groups with MannWhitney U test. Pearson chisquare test was used to compare the differences between junctional zone, T2hyperintense foci and combined application of the two in the diagnosis of adenomyosis. Results：Thirtyfive cases were diffuse adenomyosis and 21 cases were focal adenomyosis. Among 35 cases with diffuse adenomyosis, the junctional zone could not be well visualized and measured in 3 cases; the average JZmax, JZdif, and JZrat of the remaining 32 cases were 20.6 mm, 12.8 mm, and 70.1%, respectively. Among 21 cases with focal adenomyosis, the junctional zone could not be well visualized and measured in 3 cases; the average JZmax, JZdif, and JZrat of the remaining 18 cases were 16.4 mm, 10.2 mm, and 61.0%, respectively. There were significant differences in JZmax, JZdif, and JZrat between the adenomyosis group and the control group. Fortyeight (85.7%) of 56 cases in the adenomyosis group had T2hyperintense foci. The combined sensitivity, specificity and accuracy of JZmax, JZdif, and T2hyperintense foci were 92.9%, 97.1%, and 94.5%, respectively, and the sensitivity and accuracy were higher than those of individual diagnoses of JZmax and JZdif (P<0.05). Conclusions：JZmax, JZdif, JZrat and intralesional T2hyperintense foci are all valuable in the diagnosis of uterine adenomyosis, and combination of JZmax, JZdif and intralesional T2hyperintense foci can help improve the diagnostic accuracy of adenomyosis.