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A) Mirena or Liletta (52 mg LNG-IUD) CORRECT
Mirena (Bayer) and Liletta (Allergan) are progestin-releasing intrauterine devices (IUDs) of similar size and shape. On ultrasonography, both the arms and the distal tip are echogenic. The progestin-containing plastic sleeve surrounding the stem in the middle demonstrates a laminated acoustic shadowing with distinctive parallel lines.1–4
B) Small-framed LNG-IUDs: Skyla (13.5 mg) or Kyleena (19.5 mg) INCORRECT
Skyla (Bayer) and Kyleena (Bayer) are small-framed LNG-IUDs. The ultrasound appearance of Skyla (LNG 13.5 mg) is similar to that of Mirena but has a markedly echogenic silver ring superiorly just below the crossbar, best seen with 2D (sagittal) views but also imaged with 3D ultrasound.1,2,5
The Kyleena device (LNG 19.5 mg) uses the same smaller T-shaped frame and metal ring, but the plastic sleeve is longer to accommodate the greater quantity of progestin.6
C) Paragard (intrauterine copper contraceptive) INCORRECT
Paragard (Teva Women’s Health) is a nonhormonal IUD containing copper wire wrapped around its stem and solid copper bands on each crossbar. On ultrasonography, the stem is uniformly and markedly echogenic due to the copper wire.1,2,7
- Stalnaker ML, Kaunitz AM. How to identify and localize IUDs on ultrasound. OBG Manag. 2014;26(8):38,40–41,44.
- Boortz HE, Margolis DJ, Ragavendra N, Patel MK, Kadell BM. Migration of intrauterine devices: Radiologic findings and implications for patient care. Radiographics. 2012;32(2):335–352.
- Mirena [package insert]. Whippany, NJ: Bayer; 2000.
- Liletta [package insert]. Parsippany, NJ: Allergan; 2015.
- Skyla [package insert]. Whippany, NJ: Bayer; 2000.
- Kyleena [package insert]. Whippany, NJ: Bayer; 2000.
- Paragard [package insert]. North Wales, PA: Teva Women’s Health, Inc; 2014.
Dr. Kanmaniraja is Assistant Professor and Chief, Division of Abdominal Imaging, Department of Radiology, University of Florida College of Medicine–Jacksonville.
Dr. Kaunitz is University of Florida Research Foundation Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. He is Medical Director and Director of Menopause and Gynecologic Ultrasound Services at UF Women’s Health Specialists–Emerson. He also serves on the OBG Management Board of Editors.
Dr. Kaunitz reports serving on Bayer Advisory Boards. The University of FL receives research funding from Bayer. Dr. Kanmaniraja reports no additional financial relationships relevant to this quiz.
Dr. Kanmaniraja is Assistant Professor and Chief, Division of Abdominal Imaging, Department of Radiology, University of Florida College of Medicine–Jacksonville.
Dr. Kaunitz is University of Florida Research Foundation Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. He is Medical Director and Director of Menopause and Gynecologic Ultrasound Services at UF Women’s Health Specialists–Emerson. He also serves on the OBG Management Board of Editors.
Dr. Kaunitz reports serving on Bayer Advisory Boards. The University of FL receives research funding from Bayer. Dr. Kanmaniraja reports no additional financial relationships relevant to this quiz.
Dr. Kanmaniraja is Assistant Professor and Chief, Division of Abdominal Imaging, Department of Radiology, University of Florida College of Medicine–Jacksonville.
Dr. Kaunitz is University of Florida Research Foundation Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. He is Medical Director and Director of Menopause and Gynecologic Ultrasound Services at UF Women’s Health Specialists–Emerson. He also serves on the OBG Management Board of Editors.
Dr. Kaunitz reports serving on Bayer Advisory Boards. The University of FL receives research funding from Bayer. Dr. Kanmaniraja reports no additional financial relationships relevant to this quiz.
A) Mirena or Liletta (52 mg LNG-IUD) CORRECT
Mirena (Bayer) and Liletta (Allergan) are progestin-releasing intrauterine devices (IUDs) of similar size and shape. On ultrasonography, both the arms and the distal tip are echogenic. The progestin-containing plastic sleeve surrounding the stem in the middle demonstrates a laminated acoustic shadowing with distinctive parallel lines.1–4
B) Small-framed LNG-IUDs: Skyla (13.5 mg) or Kyleena (19.5 mg) INCORRECT
Skyla (Bayer) and Kyleena (Bayer) are small-framed LNG-IUDs. The ultrasound appearance of Skyla (LNG 13.5 mg) is similar to that of Mirena but has a markedly echogenic silver ring superiorly just below the crossbar, best seen with 2D (sagittal) views but also imaged with 3D ultrasound.1,2,5
The Kyleena device (LNG 19.5 mg) uses the same smaller T-shaped frame and metal ring, but the plastic sleeve is longer to accommodate the greater quantity of progestin.6
C) Paragard (intrauterine copper contraceptive) INCORRECT
Paragard (Teva Women’s Health) is a nonhormonal IUD containing copper wire wrapped around its stem and solid copper bands on each crossbar. On ultrasonography, the stem is uniformly and markedly echogenic due to the copper wire.1,2,7
A) Mirena or Liletta (52 mg LNG-IUD) CORRECT
Mirena (Bayer) and Liletta (Allergan) are progestin-releasing intrauterine devices (IUDs) of similar size and shape. On ultrasonography, both the arms and the distal tip are echogenic. The progestin-containing plastic sleeve surrounding the stem in the middle demonstrates a laminated acoustic shadowing with distinctive parallel lines.1–4
B) Small-framed LNG-IUDs: Skyla (13.5 mg) or Kyleena (19.5 mg) INCORRECT
Skyla (Bayer) and Kyleena (Bayer) are small-framed LNG-IUDs. The ultrasound appearance of Skyla (LNG 13.5 mg) is similar to that of Mirena but has a markedly echogenic silver ring superiorly just below the crossbar, best seen with 2D (sagittal) views but also imaged with 3D ultrasound.1,2,5
The Kyleena device (LNG 19.5 mg) uses the same smaller T-shaped frame and metal ring, but the plastic sleeve is longer to accommodate the greater quantity of progestin.6
C) Paragard (intrauterine copper contraceptive) INCORRECT
Paragard (Teva Women’s Health) is a nonhormonal IUD containing copper wire wrapped around its stem and solid copper bands on each crossbar. On ultrasonography, the stem is uniformly and markedly echogenic due to the copper wire.1,2,7
- Stalnaker ML, Kaunitz AM. How to identify and localize IUDs on ultrasound. OBG Manag. 2014;26(8):38,40–41,44.
- Boortz HE, Margolis DJ, Ragavendra N, Patel MK, Kadell BM. Migration of intrauterine devices: Radiologic findings and implications for patient care. Radiographics. 2012;32(2):335–352.
- Mirena [package insert]. Whippany, NJ: Bayer; 2000.
- Liletta [package insert]. Parsippany, NJ: Allergan; 2015.
- Skyla [package insert]. Whippany, NJ: Bayer; 2000.
- Kyleena [package insert]. Whippany, NJ: Bayer; 2000.
- Paragard [package insert]. North Wales, PA: Teva Women’s Health, Inc; 2014.
- Stalnaker ML, Kaunitz AM. How to identify and localize IUDs on ultrasound. OBG Manag. 2014;26(8):38,40–41,44.
- Boortz HE, Margolis DJ, Ragavendra N, Patel MK, Kadell BM. Migration of intrauterine devices: Radiologic findings and implications for patient care. Radiographics. 2012;32(2):335–352.
- Mirena [package insert]. Whippany, NJ: Bayer; 2000.
- Liletta [package insert]. Parsippany, NJ: Allergan; 2015.
- Skyla [package insert]. Whippany, NJ: Bayer; 2000.
- Kyleena [package insert]. Whippany, NJ: Bayer; 2000.
- Paragard [package insert]. North Wales, PA: Teva Women’s Health, Inc; 2014.
A 25-year-old woman using an IUD presented to her ObGyn’s office for follow-up care of a 4- to 5-cm left simple ovarian cyst. A pelvic ultrasound was performed. The ovarian cyst had resolved and a fundally-positioned IUD was imaged.