Pediatric Radiology最新文献

{"title":"Accuracy of large language models in generating differential diagnosis from clinical presentation and imaging findings in pediatric cases.","authors":"Jinho Jung, Michael Phillipi, Bryant Tran, Kasha Chen, Nathan Chan, Erwin Ho, Shawn Sun, Roozbeh Houshyar","doi":"10.1007/s00247-025-06317-z","DOIUrl":"10.1007/s00247-025-06317-z","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLM) have shown promise in assisting medical decision-making. However, there is limited literature exploring the diagnostic accuracy of LLMs in generating differential diagnoses from text-based image descriptions and clinical presentations in pediatric radiology.</p><p><strong>Objective: </strong>To examine the performance of multiple proprietary LLMs in producing accurate differential diagnoses for text-based pediatric radiological cases without imaging.</p><p><strong>Materials and methods: </strong>One hundred sixty-four cases were retrospectively selected from a pediatric radiology textbook and converted into two formats: (1) image description only, and (2) image description with clinical presentation. The ChatGPT-4 V, Claude 3.5 Sonnet, and Gemini 1.5 Pro algorithms were given these inputs and tasked with providing a top 1 diagnosis and a top 3 differential diagnoses. Accuracy of responses was assessed by comparison with the original literature. Top 1 accuracy was defined as whether the top 1 diagnosis matched the textbook, and top 3 differential accuracy was defined as the number of diagnoses in the model-generated top 3 differential that matched any of the top 3 diagnoses in the textbook. McNemar's test, Cochran's Q test, Friedman test, and Wilcoxon signed-rank test were used to compare algorithms and assess the impact of added clinical information, respectively.</p><p><strong>Results: </strong>There was no significant difference in top 1 accuracy between ChatGPT-4 V, Claude 3.5 Sonnet, and Gemini 1.5 Pro when only image descriptions were provided (56.1% [95% CI 48.4-63.5], 64.6% [95% CI 57.1-71.5], 61.6% [95% CI 54.0-68.7]; P = 0.11). Adding clinical presentation to image description significantly improved top 1 accuracy for ChatGPT-4 V (64.0% [95% CI 56.4-71.0], P = 0.02) and Claude 3.5 Sonnet (80.5% [95% CI 73.8-85.8], P < 0.001). For image description and clinical presentation cases, Claude 3.5 Sonnet significantly outperformed both ChatGPT-4 V and Gemini 1.5 Pro (P < 0.001). For top 3 differential accuracy, no significant differences were observed between ChatGPT-4 V, Claude 3.5 Sonnet, and Gemini 1.5 Pro, regardless of whether the cases included only image descriptions (1.29 [95% CI 1.16-1.41], 1.35 [95% CI 1.23-1.48], 1.37 [95% CI 1.25-1.49]; P = 0.60) or both image descriptions and clinical presentations (1.33 [95% CI 1.20-1.45], 1.52 [95% CI 1.41-1.64], 1.48 [95% 1.36-1.59]; P = 0.72). Only Claude 3.5 Sonnet performed significantly better when clinical presentation was added (P < 0.001).</p><p><strong>Conclusion: </strong>Commercial LLMs performed similarly on pediatric radiology cases in providing top 1 accuracy and top 3 differential accuracy when only a text-based image description was used. Adding clinical presentation significantly improved top 1 accuracy for ChatGPT-4 V and Claude 3.5 Sonnet, with Claude showing the largest improvement. Claude 3.5 Sonnet outperformed both","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1927-1933"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced fetal MRI diagnosis of esophageal atresia using super-resolution slice-to-volume reconstruction.","authors":"Delaney Loken, Luis F Goncalves, Mittun Patel, Nicholas Rubert","doi":"10.1007/s00247-025-06309-z","DOIUrl":"10.1007/s00247-025-06309-z","url":null,"abstract":"<p><strong>Background: </strong>Prenatal diagnosis of esophageal atresia remains challenging, with indirect signs such as polyhydramnios, a small or absent stomach bubble, and a dilated upper esophageal pouch often inconsistently present. Only 10-40% of EA cases are diagnosed prenatally. Fetal MRI can overcome ultrasound limitations; however, constraints like motion can hinder evaluation of the esophagus.</p><p><strong>Methods: </strong>Super-resolution imaging with slice-to-volume reconstruction (SVR) is one approach that can improve image quality. This technique generates high-resolution 3D images from standard fetal MRI slices to enhance diagnostic accuracy.</p><p><strong>Aim: </strong>We present the application of super-resolution imaging with SVR to accurately diagnose EA and assess the presence or absence tracheoesophageal fistulas.</p><p><strong>Conclusion: </strong>This technique demonstrates significant potential for accurately delineating the relevant surgical anatomy, which can improve surgical planning.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1943-1946"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aneurysmal bone cysts abutting the growth plate: evaluation of the impact of alcohol sclerotherapy.","authors":"Maxime Pastor, Sylvain Grange, Dimitri Daly-Eraya, Mickaël Maldinez, Marion Delpont, Catherine Cyteval","doi":"10.1007/s00247-025-06329-9","DOIUrl":"10.1007/s00247-025-06329-9","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts (ABCs) are benign bone lesions frequently observed in children and adolescents. These cysts can form in any part of the skeleton and are characterized by fluid-filled cavities surrounded by fibrous tissue.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of interventional radiology treatment by intra-cystic alcohol sclerotherapy of ABCs abutting the growth plate in pediatric patients.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted across two hospital centers between January 2012 and June 2022. The study included patients diagnosed with ABCs abutting the growth plate and treated via intra-cystic alcohol sclerotherapy. The radiographic diagnosis of ABCs was confirmed using radiographs and magnetic resonance imaging (MRI), and a biopsy was performed for definitive confirmation. The patients were followed up for a minimum of 12 months post-alcohol sclerotherapy.</p><p><strong>Results: </strong>A total of 14 patients were included in the study, with 13 active ABCs and one aggressive ABC, based on the Capanna classification. The mean clinical and radiological follow-up after sclerotherapy was 36.1 months ± 17.4 months. No epiphysiodesis was reported in any of the patients. At least 1 year after the procedure, 13 of the 14 patients did not present any pain; 12 of 14 patients did not require surgery; one patient presented with a fracture; and one presented with asymmetry of the lower limbs after surgery. New bone formation and/or increased cortical thickness were considered major in three ABCs (score I on the modified Neer classification) and significant in nine ABCs (score II on the modified Neer classification).</p><p><strong>Conclusion: </strong>Alcohol sclerotherapy of active ABCs abutting the growth plate shows no short-term complications and poses no risk of epiphysiodesis. This suggests that alcohol sclerotherapy could be a safe and effective treatment option for ABCs abutting the growth plate in pediatric patients.</p><p><strong>Clinical impact: </strong>This study supports alcohol sclerotherapy as a minimally invasive, safe, and effective treatment for pediatric ABCs near the growth plate, potentially reducing the need for surgical interventions.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1873-1882"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of neural networks for classification of urinary tract dilation from renal ultrasounds: evaluation of agreement with expert categorization.","authors":"Kee Chung, Shaoju Wu, Chow Jeanne, Andy Tsai","doi":"10.1007/s00247-025-06311-5","DOIUrl":"10.1007/s00247-025-06311-5","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract dilation (UTD) is a frequent problem in infants. Automated and objective classification of UTD from renal ultrasounds would streamline their interpretations.</p><p><strong>Objective: </strong>To develop and evaluate the performance of different deep learning models in predicting UTD classifications from renal ultrasound images.</p><p><strong>Materials and methods: </strong>We searched our image archive to identify renal ultrasounds performed in infants ≤ 3-months-old for the clinical indications of prenatal UTD and urinary tract infection (9/2023-8/2024). An expert pediatric uroradiologist provided the ground truth UTD labels for representative sagittal sonographic renal images. Three different deep learning models trained with cross-entropy loss were adapted with four-fold cross-validation experiments to determine the overall performance.</p><p><strong>Results: </strong>Our curated database included 492 right and 487 left renal ultrasounds (mean age ± standard deviation = 1.2 ± 0.1 months for both cohorts, with 341 boys/151 girls and 339 boys/148 girls, respectively). The model prediction accuracies for the right and left kidneys were 88.7% (95% confidence interval [CI], [85.8%, 91.5%]) and 80.5% (95% CI, [77.6%, 82.9%]), with weighted kappa scores of 0.90 (95% CI, [0.88, 0.91]) and 0.87 (95% CI, [0.82, 0.92]), respectively. When predictions were binarized into mild (normal/P1) and severe (UTD P2/P3) dilation, accuracies of the right and left kidneys increased to 96.3% (95% CI, [94.9%, 97.8%]) and 91.3% (95% CI, [88.5%, 94.2%]), but agreements decreased to 0.78 (95% CI, [0.73, 0.82]) and 0.75 (95% CI, [0.68, 0.82]), respectively.</p><p><strong>Conclusion: </strong>Deep learning models demonstrated high accuracy and agreement in classifying UTD from infant renal ultrasounds, supporting their potential as decision-support tools in clinical workflows.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1846-1856"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreign body-induced knee synovitis: importance of history by the radiologist.","authors":"Evangelia E Vassalou, Rozalia Dimitriou, Chryssoula Perdikogianni, Maria Raissaki","doi":"10.1007/s00247-025-06339-7","DOIUrl":"10.1007/s00247-025-06339-7","url":null,"abstract":"<p><p>We describe a case of a 7.5-year-old boy with a 7-week history of recurrent right knee swelling despite joint aspiration, persisting limping, and mild motion restriction, following a minor injury. Initial magnetic resonance imaging (MRI), ultrasound, and joint fluid analysis yielded non-specific synovitis. The child was investigated for juvenile idiopathic arthritis (JIA) and referred for a repeat MRI. Questioning by the attending radiologist disclosed falling onto wood sticks 10 weeks previously. Florid enhancing synovitis, prominent popliteal lymph nodes, and a linear foreign body were identified and ultrasonographically confirmed. During the operation, a 3-cm wooden splinter was successfully removed. This case highlights the uncommon challenge of differentiating between JIA and foreign body-induced synovitis and emphasizes the importance of detailed history by the radiologist and meticulous imaging techniques.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1947-1951"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of cine clips of the spermatic cord in the diagnosis of testicular torsion in the pediatric population.","authors":"Cassandra Sams, Eleanor DiBiasio, Rama Ayyala, Grayson Baird, Michael Furman, Alison Hart, Thaddeus Herliczek, David Swenson","doi":"10.1007/s00247-025-06312-4","DOIUrl":"10.1007/s00247-025-06312-4","url":null,"abstract":"<p><strong>Background: </strong>Indirect evidence of testicular torsion, namely lack of blood flow, has been a mainstay in the imaging diagnosis of testicular torsion. Recently, attention has been given to the etiology of testicular torsion, namely the twisted vascular pedicle. However, no study to date has demonstrated the diagnostic yield of inclusion of cine clips of the spermatic cord in identifying this twist.</p><p><strong>Objective: </strong>This study seeks to demonstrate whether the inclusion of cine clips of the spermatic cord impacts the diagnostic performance of ultrasound in diagnosing testicular torsion.</p><p><strong>Materials and methods: </strong>This study employed a multi-reader multi-case complete and balanced block cross-over design to assess the diagnostic performance of ultrasound, specifically the impact of cine clips of the spermatic cord. From 1/1/2015 to 12/31/2017, ultrasounds of 156 patients presenting with acute onset of unilateral scrotal pain were reviewed by five pediatric radiologists. Within this data set were 52 cases of surgically confirmed testicular torsion, 52 cases that were abnormal but without testicular torsion, and 52 normal exams. The data set was reviewed twice; initially, static images alone were reviewed. After a period of at least 2 weeks, the data set was again reviewed with the inclusion of cine clips of the spermatic cord. A questionnaire was answered after each review that elicited the radiologist's final diagnosis. Sensitivity and specificity between imaging features were estimated using generalized linear mixed modeling with the GLIMMIX procedure.</p><p><strong>Results: </strong>With the inclusion of cine clips of the spermatic cord, the sensitivity in diagnosing testicular torsion increased from 88.8% (95%CI 78.1-94.6%) to 98.5% (95%CI 96.0-99.5%) (P < 0.0001) with no statistically significant change to specificity 98.4% (95%CI 95.9-99.4%) to 97.0% (95%CI 94.9-98.3%) (P = 0.61).</p><p><strong>Conclusion: </strong>This study provides compelling evidence to consider cine clips of the spermatic cord as part of a standard ultrasound approach for the work-up of testicular pain due to the nearly 10% increase in sensitivity in diagnosing testicular torsion with their inclusion.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1857-1863"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of renal pseudotumors in children: a comprehensive review.","authors":"Burak Dalkıran, H Nursun Ozcan, Berna Oguz, Mithat Haliloglu","doi":"10.1007/s00247-025-06320-4","DOIUrl":"10.1007/s00247-025-06320-4","url":null,"abstract":"<p><p>Certain renal developmental anomalies and non-tumorous lesions in children may mimic malignant tumors, leading to diagnostic challenges. These lesions, known as pseudotumors, require careful differentiation to avoid unnecessary invasive procedures. In this context, imaging techniques play a critical role in differentiating pseudotumors from malignant neoplasms. Ultrasound (US) is the preferred initial imaging modality in pediatric patients. When US findings are inconclusive, magnetic resonance imaging is commonly used as the next step. Computed tomography is less commonly preferred due to ionizing radiation. It is useful to evaluate the lesion along with the clinical and laboratory findings, and the follow-up imaging may be necessary in some cases. This review presents common and uncommon developmental, infectious, granulomatous, vascular, and miscellaneous renal pseudotumors in the pediatric population.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1798-1810"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal subpial hemorrhage diagnosed by fetal magnetic resonance imaging: imaging spectrum and autopsy findings.","authors":"Stephanie Libzon, Debora Kidron, Uri Erlik, Karina Krajden-Haratz, Moran Hausman-Kedem, Liat Ben Sira","doi":"10.1007/s00247-025-06353-9","DOIUrl":"10.1007/s00247-025-06353-9","url":null,"abstract":"<p><p>Subpial hemorrhage is a rare intracranial hemorrhage typically described in neonates. We report the first prenatal diagnosis of subpial hemorrhage in a 28-year-old primigravida, defined on fetal magnetic resonance imaging (MRI) by its hallmark cortical inward depression (\"cortical buckling\") and restricted diffusion on the apparent diffusion coefficient map, and later confirmed by autopsy. This case implicates intrinsic fetal factors-rather than birth trauma or neonatal asphyxia-in subpial hemorrhage pathogenesis and highlights the critical role of fetal MRI in distinguishing subpial hemorrhage from other fetal hemorrhages, with important implications for prenatal counseling and perinatal management.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1952-1956"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encephalocraniocutaneous lipomatosis-a neuroradiological perspective.","authors":"Dhrumil Deveshkumar Patel, Karen W Gripp, Paige Mcdunnah, Ishita Mishra, Vinay Kandula","doi":"10.1007/s00247-025-06346-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06346-8","url":null,"abstract":"<p><p>This report aims to demonstrate the phenotypic, radiological, and genetic features of encephalocraniocutaneous lipomatosis (ECCL), a rare neurocutaneous disorder characterized by a distinct triad of congenital skin lesions, ocular anomalies, and central nervous system (CNS) abnormalities. The mosaic nature of ECCL puts the radiologist in a unique position to facilitate its prompt diagnosis. In the patient reported here, pulmonic stenosis and facial dysmorphism initially raised the suspicion of Noonan syndrome, which was unsupported by genetic testing. Serial imaging revealed multiple intracranial lipomas and glioma along with a clinically evident nevus psiloliparus, prompting further genetic evaluation. This identified a novel de novo variant in FGFR1 (c.1685A > C, p.Glu562Ala). The variant appeared heterozygous in blood and cheek swab cells derived DNA, contrasting with the typical mosaic nature of variants in ECCL.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and factors associated with serosal and soft tissue enhancement after cardiac catheterization in infants.","authors":"Akhil Dhamija, Joshua D Wermers, Sarosh P Batlivala, Yinan Li, Bin Zhang, Alexander J Towbin","doi":"10.1007/s00247-025-06343-x","DOIUrl":"10.1007/s00247-025-06343-x","url":null,"abstract":"<p><strong>Background: </strong>Diffuse serosal and soft tissue enhancement is a rare imaging phenomenon observed in infants following cardiac catheterization. The appearance of serosal and soft tissue enhancement can mimic pneumoperitoneum, potentially leading to misdiagnosis and unnecessary diagnostic procedures. While serosal and soft tissue enhancement has been documented in case reports, no studies have systematically evaluated the risk factors associated with its development.</p><p><strong>Objective: </strong>To determine the frequency of serosal and soft tissue enhancement in infants following cardiac catheterization and identify clinical and imaging factors associated with this phenomenon.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed infants who underwent cardiac catheterization at our institution between January 2010 and September 2019. Abdominal radiographs obtained within 2 days of the procedure were independently reviewed by three pediatric radiologists for the presence of serosal and soft tissue enhancement. Clinical data, including contrast dose, renal function, and cardiac physiology, were extracted from the electronic medical record. Statistical analysis, including t-tests and logistic regression, was performed to identify factors associated with serosal and soft tissue enhancement, with inter-observer reliability assessed using the Fleiss kappa test.</p><p><strong>Results: </strong>Among 1,796 infants who underwent cardiac catheterization, 294 had follow-up abdominal radiographs. Serosal and soft tissue enhancement was identified as present by all three radiologists in 21 patients (7.1%). Significant factors associated with serosal and soft tissue enhancement included lower pre- and post-catheterization creatinine levels (pre- 0.36 ± 0.17 vs 0.46 ± 0.30 mg/dL; P=0.043; post- 0.35 ± 0.11 vs 0.45 ± 0.29 mg/dL; P=0.009), higher contrast volume (31.8 ± 21.4 vs 21.0 ± 18.1 mL; P=0.013), and higher contrast volume per body surface area (123.0 ± 69.2 vs 80.8 ± 56.2 mL/m^2; P=0.002). Serosal and soft tissue enhancement occurred more frequently in patients with bi-ventricular cardiac physiology (125/294; 42.5% compared to 169/294; 57.5%).</p><p><strong>Conclusion: </strong>Serosal and soft tissue enhancement occurs in a small proportion of neonates following cardiac catheterization and is associated with higher contrast dosages and body surface area-adjusted contrast volumes. Awareness of serosal and soft tissue enhancement among pediatric radiologists is helpful to avoid misdiagnosis of pneumoperitoneum.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1864-1872"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}