E5191. IUD or IUDon’t: Normal Appearance and Complications of Pelvic Devices and Reproductive Interventions
  1. Michelle Kim; NYU Langone Health
  2. Kira Melamud; NYU Langone Health
  3. Chrystia Slywotzky; NYU Langone Health
  4. Robert Petrocelli; NYU Langone Health
  5. Vinay Prabhu; NYU Langone Health
The increasing prevalence of pelvic devices and reproductive interventions, including contraceptive devices, sterilization, and fertility treatments, has placed growing demands on radiologists for proper identification, description, and diagnosis of complications. For example, between 2002 to 2014, intrauterine device (IUD) use amongst women using contraception in the US increased from 2% to 14%. Radiologists are pivotal in evaluating device placement and identifying postintervention complications. However, many reproductive treatments require specific knowledge of normal appearance on multiple modalities, and complications may be subtle depending on the imaging modality used. Furthermore, obsolete devices remain important despite their infrequent use, as patients may retain them and face long-term risks. Therefore, radiologists must be familiar with both normal and abnormal appearances of common and uncommon pelvic devices and reproductive interventions, maintaining a broad differential when approaching their complications. This exhibit will provide a multimodal review of various reproductive interventions that radiologists encounter in practice, such as IUDs, tubal occlusion, and ligation procedures, and assisted reproductive technology. Through a series of cases, we will highlight imaging pearls and pitfalls when diagnosing their associated complications.

Educational Goals / Teaching Points
1. Review pelvic devices, such as contraceptive devices, and other reproductive interventions that radiologists may encounter, including their functions, components, and appropriate positions for optimal efficacy. 2. Identify useful imaging modalities for evaluating devices and therapies used in reproductive medicine. 3. Recognize defining imaging features to confirm normal device placement or posttreatment appearance. 4. Present case-based review of common and uncommon complications, including migration, malposition, infection, and unintended pregnancy, highlighting key clinical pearls and pitfalls to aid diagnosis. 5. Demonstrate the importance of radiology reporting in communicating and triaging findings associated with these interventions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit showcases reproductive interventions and complications in these categories: contraceptives, sterilization, fertility treatments, and nonreproductive devices. We will describe how to identify normal imaging appearances across multiple modalities, including ultrasound, x-ray, fluoroscopy, CT, and MRI. Examples will include complications from IUDs (perforation, migration to distant sites, ectopic pregnancy), tubal and vas deferens occlusion, and in-vitro fertilization scenarios (ovarian hyperstimulation syndrome, multiple pregnancies).

The presence of devices and reproductive interventions in the pelvis can be a potential challenge for radiologists, particularly when encountering less common or obsolete devices, along with rarer complications. Becoming familiar with the normal appearances of these devices and interventions across imaging modalities is instrumental for timely diagnosis and management.