Whole-body CT characteristics of patients with severe fever with thrombocytopenia syndrome
4 affiliations
- 1Department of Radiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
- 2Department of Radiology, Oita Prefectural Hospital, Oita, Japan
- 3Department of Emergency Medicine, Faculty of Medicine, Oita University, Yufu, Japan
- 4Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Yufu, Japan
Abstract
Purpose: To characterize the computed tomography (CT) features of severe fever with thrombocytopenia syndrome (SFTS) and to identify imaging features predictive of an adverse prognosis.
Materials and methods: Thirty-one patients diagnosed with SFTS between July 2017 and August 2025 and who underwent whole-body CT (17 men, 14 women; mean age, 75.3 years; 24 survivors, 7 non-survivors) were retrospectively reviewed. CT findings of the chest, abdominal organs, and regional lymph nodes were assessed. Initial CT scans (n = 31) were obtained a mean of 3.8 days (range, 0–7) after symptom onset, and follow-up CT scans (n = 20) were performed in 17 patients a mean of 6.0 days (range 1–18) after the initial scan, giving a total of 51 examinations. Additionally, for three cases in which autopsy was performed, correlation analysis was performed between the CT findings and pathological findings.
Results: On initial CT, the most frequent finding was regional lymphadenopathy (n = 30, 96.8%), most commonly involving inguinal (n = 17, 54.8%) and axillary nodes (n = 11, 35.5%). Perinodal fat stranding was observed in 29 patients (93.5%). The most common thoracic finding was ground-glass opacity (GGO) (n = 17, 54.8%), followed by bronchial wall thickening (n = 16, 51.6%) and interlobular septal thickening (n = 15, 48.4%). Among abdominal organs, splenomegaly was the most frequent finding (n = 25, 80.6%), followed by renal enlargement (n = 15, 48.4%). On follow-up CT, the most frequently observed changes compared with the initial CT were increased renal volume (n = 17, 85%) and increased hepatic volume (n = 14, 70%). GGO was significantly more frequent in non-survivors than in survivors.
Conclusions: Characteristic CT findings of SFTS include regional lymphadenopathy with perinodal fat stranding, followed by splenomegaly and GGO. GGO may be an imaging finding predictive of an adverse prognosis.
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BibTeX
@article{sato2026wholebody,
title = {{Whole-body CT characteristics of patients with severe fever with thrombocytopenia syndrome}},
author = {Haruka Sato and Fumito Okada and Ryuichi Takenaka and Ryuzo Abe and Haruto Nishida and Yoshiki Asayama},
journal = {Japanese Journal of Radiology},
year = {2026},
month = jul,
doi = {10.1007/s11604-026-02044-z},
url = {https://doi.org/10.1007/s11604-026-02044-z},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Whole-body CT characteristics of patients with severe fever with thrombocytopenia syndrome
AU - Haruka Sato
AU - Fumito Okada
AU - Ryuichi Takenaka
AU - Ryuzo Abe
AU - Haruto Nishida
AU - Yoshiki Asayama
PY - 2026
DA - 2026/07/01
JO - Japanese Journal of Radiology
DO - 10.1007/s11604-026-02044-z
UR - https://doi.org/10.1007/s11604-026-02044-z
AB - Purpose: To characterize the computed tomography (CT) features of severe fever with thrombocytopenia syndrome (SFTS) and to identify imaging features predictive of an adverse prognosis. Materials and methods: Thirty-one patients diagnosed with SFTS between July 2017 and August 2025 and who underwent whole-body CT (17 men, 14 women; mean age, 75.3 years; 24 survivors, 7 non-survivors) were retrospectively reviewed. CT findings of the chest, abdominal organs, and regional lymph nodes were assessed. Initial CT scans (n = 31) were obtained a mean of 3.8 days (range, 0–7) after symptom onset, and follow-up CT scans (n = 20) were performed in 17 patients a mean of 6.0 days (range 1–18) after the initial scan, giving a total of 51 examinations. Additionally, for three cases in which autopsy was performed, correlation analysis was performed between the CT findings and pathological findings. Results: On initial CT, the most frequent finding was regional lymphadenopathy (n = 30, 96.8%), most commonly involving inguinal (n = 17, 54.8%) and axillary nodes (n = 11, 35.5%). Perinodal fat stranding was observed in 29 patients (93.5%). The most common thoracic finding was ground-glass opacity (GGO) (n = 17, 54.8%), followed by bronchial wall thickening (n = 16, 51.6%) and interlobular septal thickening (n = 15, 48.4%). Among abdominal organs, splenomegaly was the most frequent finding (n = 25, 80.6%), followed by renal enlargement (n = 15, 48.4%). On follow-up CT, the most frequently observed changes compared with the initial CT were increased renal volume (n = 17, 85%) and increased hepatic volume (n = 14, 70%). GGO was significantly more frequent in non-survivors than in survivors. Conclusions: Characteristic CT findings of SFTS include regional lymphadenopathy with perinodal fat stranding, followed by splenomegaly and GGO. GGO may be an imaging finding predictive of an adverse prognosis.
SN - 1867-1071
SN - 1867-108X
ER -