Radiographic, Sonographic, and MRI Appearance of the Essure Device

The Essure microinsert is a hysteroscopically placed permanent contraceptive device made of an inner flexible metallic coil surrounded by an outer metallic coil. The ends of each coil have radiopaque markers.

The device measures 4 cm in length. The inner coil sticks out at one end, and the outer coil sticks out at the other. The inner coil end is inserted into the fallopian tube. The device is considered optimally placed when 5-10 mm of the outer coil stick out into the endometrial cavity.

Hysterosalpingography can be used to document the position of the device and patency of the tubes after device placement. Here we see a scout view of a hysterosalpingogram showing two micro-inserts on the right and one on the left.

On ultrasound, the outer coil shows up as two parallel interrupted echogenic lines that protrude into the endometrial cavity. The central coil may or may not be seen.

On MRI, there is linear loss of signal in the region of the fallopian tubes.

Complications include device expulsion, tubal perforation, and pregnancy.

References

Wittmer MH, et al. Sonography, CT, and MRI appearance of the Essure microinsert permanent birth control device. AJR Am J Roentgenol. 2006 Oct;187(4):959-64.