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Visible Pneumatosis in Necrotizing Enterocolitis at 100% Oxygen Supplementation?

Hi, hope this is an appropriate question for this sub.

Currently studying for a licensing exam in Germany and have come across the info in various textbooks that pneumatosis is not always visible/ a reliable sign of NEC if the infant is being supplemented with 100% O2. Why is this the case? It's hard to find info on this as it's uncommon for the infant to be getting 100% O2 anyway for obvious reasons, but I would appreciate your feedback and ideas!

Edit: I'm asking specifically about an abdominal X-ray, forgot to mention this.

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source https://www.reddit.com/r/Radiology/comments/jgn8sl/visible_pneumatosis_in_necrotizing_enterocolitis/

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