{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:06:46Z","timestamp":1757621206049,"version":"3.44.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>This retrospective study analyzed infants who underwent cardiac catheterization at our institution between January 2010 and September 2019. Abdominal radiographs obtained within 2\u00a0days 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 <jats:italic>t<\/jats:italic>-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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>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\u2009\u00b1\u20090.17 vs 0.46\u2009\u00b1\u20090.30\u00a0mg\/dL; <jats:italic>P<\/jats:italic>=0.043; post- 0.35\u2009\u00b1\u20090.11 vs 0.45\u2009\u00b1\u20090.29\u00a0mg\/dL; <jats:italic>P<\/jats:italic>=0.009), higher contrast volume (31.8\u2009\u00b1\u200921.4 vs 21.0\u2009\u00b1\u200918.1\u00a0mL; <jats:italic>P<\/jats:italic>=0.013), and higher contrast volume per body surface area (123.0\u2009\u00b1\u200969.2 vs 80.8\u2009\u00b1\u200956.2\u00a0mL\/m^2; <jats:italic>P<\/jats:italic>=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%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00247-025-06343-x","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T10:34:14Z","timestamp":1754130854000},"page":"1864-1872","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and factors associated with serosal and soft tissue enhancement after cardiac catheterization in infants"],"prefix":"10.1007","volume":"55","author":[{"given":"Akhil","family":"Dhamija","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua D.","family":"Wermers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarosh P.","family":"Batlivala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Towbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"6343_CR1","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1007\/s00247-011-2249-2","volume":"42","author":"GG Behr","year":"2012","unstructured":"Behr GG, Berdon WE, Griscom NT (2012) Transient enhancement of pericardium, peritoneum, soft tissues and perhaps lymphatics after large doses of contrast administration: an overlooked phenomenon? Pediatr Radiol 42:750\u2013752","journal-title":"Pediatr Radiol"},{"key":"6343_CR2","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1007\/s00247-013-2796-9","volume":"43","author":"R Hong","year":"2013","unstructured":"Hong R, Behr GG, Berdon W, Ruzal-Shapiro C (2013) Transient serosal enhancement mimicking pneumoperitoneum. Pediatr Radiol 43:1662\u20131663","journal-title":"Pediatr Radiol"},{"key":"6343_CR3","doi-asserted-by":"publisher","first-page":"919","DOI":"10.2214\/ajr.131.5.919","volume":"131","author":"NT Griscom","year":"1978","unstructured":"Griscom NT (1978) Total body opacification. AJR Am J Roentgenol 131:919\u2013925","journal-title":"AJR Am J Roentgenol"},{"key":"6343_CR4","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s10140-014-1211-7","volume":"21","author":"LL Avery","year":"2014","unstructured":"Avery LL, Jain VR, Cohen HW, Scheinfeld MH (2014) High attenuation pericardial fluid on CT following cardiac catheterization. Emerg Radiol 21:381\u2013386","journal-title":"Emerg Radiol"},{"key":"6343_CR5","doi-asserted-by":"publisher","first-page":"e103","DOI":"10.1016\/j.amjms.2023.07.007","volume":"366","author":"IT Chen","year":"2023","unstructured":"Chen IT, Wang TY, Yang CY (2023) Vicarious contrast medium excretion. Am J Med Sci 366:e103\u2013e104","journal-title":"Am J Med Sci"},{"key":"6343_CR6","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1136\/archdischild-2020-321302","volume":"107","author":"LK Harrington","year":"2022","unstructured":"Harrington LK, Bautista-Rodriguez C, Gomez A et al (2022) Vicarious excretion of contrast material in a neonate. Arch Dis Child Fetal Neonatal Ed 107:335","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"6343_CR7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s13244-011-0131-2","volume":"3","author":"RW Katzberg","year":"2012","unstructured":"Katzberg RW, Monsky WL, Prionas ND et al (2012) Persistent CT nephrograms following cardiac catheterisation and intervention: initial observations. Insights Imaging 3:49\u201360","journal-title":"Insights Imaging"}],"container-title":["Pediatric Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-025-06343-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00247-025-06343-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-025-06343-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T12:17:00Z","timestamp":1757333820000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00247-025-06343-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,2]]},"references-count":7,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["6343"],"URL":"https:\/\/doi.org\/10.1007\/s00247-025-06343-x","relation":{},"ISSN":["1432-1998"],"issn-type":[{"type":"electronic","value":"1432-1998"}],"subject":[],"published":{"date-parts":[[2025,8,2]]},"assertion":[{"value":"4 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AJT: Author Royalties- Elsevier; Travel\u2014Merative; Research\u2014Bayer All Others: No competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}