ObjectiveTo analyze the multi-slice spiral CT findings of pelvic organ torsion and to discuss the value of multi-slice spiral CT applied to the diagnosis of pelvic organ torsion. MethodsThe multi-slice spiral CT findings of the patients pathologically diagnosed as pelvic organ torsion were retrospectively analyzed. All cases received three-phase scanning including arterial phase (30 seconds), venous phase (60 seconds) and delayed phase (180 seconds). ResultsOne case was diagnosed as sigmoid, and sigmoid transposition and ‘bird-beak’ appearance were observed in CT. Two cases were diagnosed as ileum volvulus complicated with bowel necrosis, ‘coffee-bean’ sign and pneumatosis intestinalis were observed in CT. Four cases were diagnosed as superior mesenteric artery volvulus complicated with intestinal ischemia, ‘whirlpool’ sign was observed in CT. Three cases were diagnosed as pedicle torsion of ovarian mucinous cystadenoma including 2 cases located on left side and 1 case on right side, cystic mass and septum, thickened septum, soft tissue pedicle were observed in CT and lightly intensification was observed when enhancement; Two cases were diagnosed as pedicle torsion of right ovarian granulosa cell tumor, cystic solid mass was observed in CT. Three cases were diagnosed as pedicle torsion of right ovarian benign cystic teratoma, asymmetrical thickened cystic wall, slight thickening cystic wall in mild torsion, obvious thickening cystic wall in severe torsion were observed in CT, and no obvious intensification was observed when enhancement. Five cases were diagnosed as ovarian cyst torsion including 3 cases located on right side and 2 cases on left side, enlarged cyst, increased density, and shifting cyst were observed in short-term CT review. Two cases were diagnosed as hydrosalpinx with torsion, thickened cystic wall and high-density hemorrhage were observed in CT. One case was diagnosed as left cryptorchidism with malignant transformation and torsion, no obvious intensification was found but pneumatosis and disappeared ipsilateral spermatic cord and testicle were observed in CT. One case was diagnosed as left spermatic cord torsion, thickened and indistinct spermatic cord and ipsilateral testicle with weakened intensification were observed in CT. ConclusionThe CT findings of pelvic organ torsion is various. Volvulusis is characterized by ‘whirlpool’ sign and ‘bird-beak’ appearance. Enlarged pedicle with edema and weakened intensification and cystic-solid ‘double mass’ originated in the primary tumor indicated ovarian cystadenoma torsion.The cystic wall thickness of benign cystic teratoma is correlated to the degree of torsion. The disappearance of ipsilateral spermatic cord indicated cryptorchidism. Multi-slice spiral CT is significant for the preoperative diagnosis of pelvic organ torsion.

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