E1690. CT Imaging of the IUD: Expected Findings, Unexpected Findings, and Complications
Authors
Grace Zhu;
University of Utah Health
Daniel Ludwig;
Washing University School of Medicine
Douglas Rogers;
University of Utah Health
Jeffrey Olpin;
University of Utah Health
Emily Barker;
Washing University School of Medicine
David Eisenberg;
Washing University School of Medicine
Cary Siegel;
Washing University School of Medicine
Background
Intrauterine devices (IUDs) are frequently used and are available in two forms, copper-containing and levonorgestrol-releasing IUDs. With any medical intervention, there are complications and side effects that radiologists should be aware of. Ultrasound is often used as the initial imaging modality, especially 3D ultrasound. CT is frequently performed and especially used to evaluate intra-abdominal IUDs and potential complications. Currently, there are several reviews of the appearances of IUD complications with a focus on ultrasound. Prior reviews of the CT appearances of various foreign bodies in the pelvis exist, however, to our knowledge, there is no dedicated pictorial review of the range of MDCT appearances of uncomplicated and complicated IUDs.
Educational Goals / Teaching Points
After viewing this exhibit, the reader will be able to understand the approach in evaluating the CT appearance of an intrauterine device and recognize a normally positioned intrauterine device, and recognize the CT imaging appearance of wide spectrum of complications involving the intrauterine device.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review the following pathophysiologic issues and imaging findings. Introduction types of IUDs, approach to evaluating IUDs on CT, normal Imaging appearance of an appropriately positioned IUD. Complicated IUDs, malpositioned IUD, low lying IUD, intracervical IUD, rotated IUD/Upside Down IUD, embedded IUD, extrauterine IUD, fragmented IUD, pregnancy and IUD, ectopic pregnancy, intrauterine pregnancy. Miscellaneous actinomycoses and IUDs, fibroids and IUDS, and mullerian abnormalities and IUDs.
Conclusion
While ultrasound is considered the first line imaging modality in evaluating the IUD, IUDs are frequently seen on abdominal and pelvic CTs due to its prevalence among women. It is important for a radiologist to be aware of the wide spectrum of normal IUDs and the various complications and their corresponding imaging findings.
