Location of intrauterine devices: evaluation by computed tomography.

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Abstract
A 21-year old white multiparous woman who had undergone a Copper-7 IUD insertion 6 days before hospital admission for abdominal pain reported she could not locate her IUD string. A slight bleeding from the cervical os was noted upon pelvic examination, and no IUD string was found. Ultrasonic B-mode scanning was performed, but the pathognomonic signs of an IUD (e.g., shadowing or entrance-exit echoes) were not seen. A digital scout view, obtained with a GE CT/T 8000 scanner showed the IUD within the pelvis. Laparoscopy was performed to remove the IUD, and the patient recovered uneventfully. The previous definitive procedure for locating IUD position was hysterosalpingography (HSG) but this technique is now used only when the sonographic and plain radiographic findings are equivocal. CT is a much easier, faster, and less invasive procedure than HSG and just as definitive; it also has the advantage of lower patient irradiation, with about 2 rad (0.02 Gy) skin dose and about 0.2 rad (0.002 Gy) gonadal dose for a single section. Fluoroscopy during HSG may deliver 0.5-1.0 rad/minute (0.005-0.01 Gy/minute) to the gonads. Patient irradiation may be minimized by a digital scout view of the pelvis. It is possible to perform the entire examination with only 1 axial scan, as in this patient, by accurately aligning the scanner.

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