
Simon G RobbenMaastricht Universitair Medisch Centrum · Radiology
Simon G Robben
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186
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Introduction
Skills and Expertise
Publications
Publications (186)
Aim:
To compare the diagnostic value and accuracy of post-mortem magnetic resonance imaging (PMMRI) and autopsy for non-cardiac thoracic and abdominal abnormalities in fetal death.
Materials and methods:
This single-institution retrospective study included all consecutive cases of fetal and perinatal death between January 2015 and December 2021...
Pelvic fractures in paediatric and adolescent patients are uncommon, accounting for about 0.3–4% of all paediatric fractures. These fractures may indicate serious other injuries, and thus need a thorough work-up. Most pelvic fractures are the result of accidental trauma, or in case of avulsion fractures because of sports related activities. Only in...
Fractures of the extremities are the most common fractures in infancy and childhood, they often occur accidentally making it sometimes difficult to discriminate them from inflicted trauma. In this chapter fractures of both the upper and lower extremity, the epidemiology, the trauma mechanisms, and the differential diagnoses are discussed. The fract...
Injuries to the spine can range from relatively mild ligament and muscle strains, to fractures, dislocations, or subluxation of the vertebrae with subsequent risk of damage to the spinal cord. Fractures and dislocations of the vertebrae can occur at all levels in the spine and in all parts of a vertebra. Spinal fractures are extremely rare in child...
The shoulder joint is composed of the scapula, clavicle, and the head of the humerus. The scapula is part of three joints: the acromioclavicular joint (acromion and clavicula), the glenohumeral joint (glenoid and proximal humerus), and the scapulothoracic joint (anterior scapula and posterior thorax) (Fig. 10.1) [1]. In this constellation, the scap...
A fracture is a partial or complete disruption of the continuity of bone or cartilage, due to mechanical forces exceeding the strength of the bone or cartilage to withstand these forces.Fractures are common in children. In a large Swedish study, the overall annual incidence of fractures in children was 2.1% (2.6 for boys; 1.7 for girls). Most fract...
Fractures of the clavicle are amongst the most frequently diagnosed fractures, in children as well as in adults. In children it is one of the most common fractures with an estimated incidence of 5 to 15% of childhood fractures. Clavicle fractures may result from a direct or an indirect trauma. This chapter describes the circumstances under which cl...
In 1946, the paediatric radiologist John P. Caffey was the first to describe the relation between the presence of multiple fractures of the long bones and subdural haematomas in six children in whom no previous trauma was known. Since then, radiology plays a pivotal role in the detection and description of fractures related to potential child abuse...
In a forensic medical setting the radiologist, pathologist, and/or anthropologist is often asked by the police or prosecution to assess the age of a fracture. In living victims, dating is focused on the time elapsed between the traumatic event and the imaging or examination of the fracture. In deceased victims, the fracture age may be used to asses...
Diagnosing non-accidental injury is a challenging task. Missing the diagnosis may have fatal consequences for the child because no measures will be taken to prevent future injury. On the other hand, a wrongful diagnosis of non-accidental injury may have severe consequences for both caretakers as well as the child, e.g. judicial prosecution of the c...
Sternum fractures in children are very rare (0.004-0.07% of all paediatric fractures) with an increasing incidence with age. Sternum fractures may result from a direct or an indirect trauma. Most cases are the result of falls or high velocity trauma mechanisms. This chapter describes the circumstances under which sternum fractures occur with emphas...
Background:
Developmental Dysplasia of the Hip (DDH) is one of the most common pediatric orthopedic disorders, affecting 1-3% of all newborns. The optimal treatment of centered DDH is currently under debate. This randomized controlled trial aims to study the (cost-)effectiveness of active monitoring versus abduction treatment for infants with cent...
Background:
Natural language processing (NLP) is thought to be a promising solution to extract and store concepts from free text in a structured manner for data mining purposes. This is also true for radiology reports, which still consist mostly of free text. Accurate and complete reports are very important for clinical decision support, for insta...
Purpose
Rectal atresia (RA) is a rare type of anorectal malformation (ARM), occurring in 1–2% of ARM. Discussion remains on optimal treatment strategy for RA. The aim of this study was to present a minimally invasive method to treat patients with membranous RA: ultrasonography guided puncture and dilatation.
Cases
Three children are described (1 f...
Objectives:
Diffusion-weighted imaging may be useful as part of a postmortem magnetic resonance imaging protocol. However, apart from the effect of temperature on apparent diffusion coefficient (ADC), normal postmortem ADC changes can influence the interpretation. Therefore, this study was conducted to evaluate the correlation between normal ADC c...
Background and purpose
Diagnostics and treatment of developmental dysplasia of the hip (DDH) are highly variable in clinical practice. To obtain more uniform and evidence-based treatment pathways, we developed the ‘Dutch guideline for DDH in children < 1 year’. This study describes recommendations for unstable and decentered hips.
Materials and me...
Child abuse is defined by the WHO as all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power (World Health Or...
Despite the high incidence of developmental dysplasia of the hip (DDH), treatment is very diverse. Therefore, the Dutch Orthopedic Society developed a clinical practice guideline with recommendations for optimal and uniform treatment of DDH. This article summarizes the guideline on centered DDH (i.e. Graf types 2A–C).
The guideline development foll...
Objectives:
Magnetic resonance imaging (MRI) is increasingly used in postmortem fetal imaging. Several factors influence the quality of MRI in this setting, such as small size, autolytic and maceration changes, and temperature. Knowing the fetal temperature at the time of scanning can improve the MRI interpretation. Temperature can be calculated u...
BACKGROUND
Natural language processing (NLP) is thought to be a promising solution to extract and store concepts from free text in a structured manner for data mining purposes. This is also true for radiology reports, which still consist mostly of free text. Accurate and complete reports are very important for clinical decision support, for instanc...
Background
In the era of datafication, it is important that medical data are accurate and structured for multiple applications. Especially data for oncological staging need to be accurate to stage and treat a patient, as well as population-level surveillance and outcome assessment. To support data extraction from free-text radiological reports, Dut...
Objectives
Data on normal mandibular development in the infant is lacking though essential to understand normal growth patterns and to discriminate abnormal growth. The aim of this study was to provide normal linear measurements of the mandible using computed tomography performed in infants from 0 to 2 years of age.
Material and methods
3D voxel s...
Objectives
Structured reporting (SR) in radiology reporting is suggested to be a promising tool in clinical practice. In order to implement such an emerging innovation, it is necessary to verify that radiology reporting can benefit from SR. Therefore, the purpose of this systematic review is to explore the level of evidence of structured reporting...
Radiologists can visually detect abnormalities on radiographs within 2s, a process that resembles holistic visual processing of faces. Interestingly, there is empirical evidence using functional magnetic resonance imaging (fMRI) for the involvement of the right fusiform face area (FFA) in visual-expertise tasks such as radiological image interpreta...
Structured reporting is advocated as a means of improving reporting in radiology to the ultimate benefit of both radiological and clinical practice. Several large initiatives are currently evaluating its potential. However, with numerous characterizations of the term in circulation, "structured reporting" has become ambiguous and is often confused...
Objectives
To confirm that structured reporting of CT scans using ten signs in clinical practice leads to a better accuracy in diagnosing internal herniation (IH) after gastric bypass surgery, compared with free-text reporting.Methods
In this prospective study, CT scans between June 1, 2017, and December 1, 2018, were included from a cohort of 2606...
Reports are the standard way of communication between the radiologist and the referring clinician. Efforts are made to improve this communication by, for instance, introducing standardization and structured reporting. Natural Language Processing (NLP) is another promising tool which can improve and enhance the radiological report by processing free...
Aim: To investigate whether full-field digital mammography (FFDM) and contrast-enhanced mammography (CEM), evaluated by non-experienced high school students, improves detection of missed breast cancer lesions on FFDM, in the same cohort of patients.
Methods: Non-experienced first- and second year high school students examined fourteen cases of pati...
Context
Medical image perception training generally focuses on abnormalities, whereas normal images are more prevalent in medical practice. Furthermore, instructional sequences that let students practice prior to expert instruction (inductive) may lead to improved performance compared with methods that give students expert instruction before practi...
Objectives:
The incidence of children developing metachronous contralateral inguinal hernia (MCIH) is 7-15%. Contralateral groin exploration during unilateral hernia repair can prevent MCIH development and subsequent second surgery and anaesthesia. Preoperative ultrasonography is a less invasive strategy and potentially able to detect contralatera...
The interpretation of chest radiographs is a complex task that is prone to diagnostic error, especially for medical students. The aim of this study is to investigate the extent to which medical students benefit from the use of a checklist regarding the detection of abnormalities on a chest radiograph. We developed a checklist based on literature an...
Children are not small adults. The pediatric musculoskeletal system differs from the adult musculoskeletal system in many ways. These differences account for many unique features in pediatric musculoskeletal imaging:
Educators in medical image interpretation have difficulty finding scientific evidence as to how they should design their instruction. We review and comment on 81 papers that investigated instructional design in medical image interpretation. We distinguish between studies that evaluated complete offline courses and curricula, studies that evaluated...
Purpose:
Systematic viewing of images is widely advocated in radiology; it is expected to lead to complete coverage of images and consequently more detection of abnormalities. Evidence on the efficacy of teaching systematic viewing to students is conflicting. The aim of this study was to investigate the effects of teaching systematic viewing to fi...
Research on visual expertise in radiology has found distinct differences between beginners and experts evaluating medical images: Experts have superior skills in detection and interpretation of abnormalities, are faster and view a smaller proportion of the image. However, all previous studies used a between-group methodology. How and when detection...
Functional neuroimaging is a hot topic in educational research. It promises insight into the functioning of the learners' mind. Functional magnetic resonance imaging (fMRI) is a non-invasive functional-neuroimaging technique to measure brain activation. Since 'active' brain regions use (and thus need) more oxygen, differences in blood oxygenation i...
Multiple ostechondromas (MO) is an autosomal dominant inherited disease caused by mutated exostosin genes. It mostly affects the long bones and can lead to growth disturbances, especially disproportionate short stature. Both the local effect on growth plates and the systemic influence of the gene disorder on growth mechanisms might explain the dimi...
Radiologists commonly use comparison films to improve their differential diagnosis. Educational literature suggests that this technique might also be used to bolster the process of learning to interpret radiographs. We investigated the effectiveness of three comparison techniques in medical students, whom we invited to compare cases of the same dis...
To prevent radiologists from overlooking lesions, radiology textbooks recommend “systematic viewing,” a technique whereby anatomical areas are inspected in a fixed order. This would ensure complete inspection (full coverage) of the image and, in turn, improve diagnostic performance. To test this assumption, two experiments were performed. Both expe...
Pulmonary artery aneurysm is a rare entity with a wide variety of underlying pathophysiological mechanisms. We report a 7-year-old boy who initially presented with suspected Lemierre's syndrome (tonsillitis and jugular vein thrombosis). However, follow-up imaging studies showed progression of the thromboembolic changes into multiple dural venous st...
The retroperitoneal space literally means the (potential) space behind the parietal peritoneum of the abdominal cavity. It has no distinct borders; also, structures that lie between the parietal peritoneum and abdominal wall can be classified as retroperitoneal, at the ventral side sometimes referred to as properitoneal. It extends from the pelvic...
The diagnosis of congenital and acquired pathologies of the gastrointestinal (GI) tract in children is quite challenging, and this is an understatement for many reasons. First, it involves a large number of diseases, many of which are not well known by general radiologists. Second, young children are not capable of verbal communication (although cr...
To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims.
We included all AHT cases in the Netherlands in the period 2005-2012 for which a forensic report was written for a court of law, and for which imaging was available for rea...
Fracturen zijn na hematomen, contusies van de huid en brandwonden de meest voorkomende letsels bij kindermishandeling. Naar schatting zijn bij 20% van de slachtoffers van fysieke kindermishandeling fracturen het eerste signaal. Fracturen die het gevolg zijn van kindermishandeling, wijzen over het algemeen op een ernstige vorm van kindermishandeling...
Radiologists advocate 'systematic viewing' as a way to avoid missing abnormalities while diagnosing chest x-rays. Systematic viewing refers to keeping to a fixed order of inspecting anatomical areas and is thought to ensure that the entire image is inspected. We investigated this using two ways of defining AOIs: based on anatomical regions (semanti...
Comparison learning is a promising approach for learning complex real-life visual tasks. When medical students study radiological appearances of diseases, comparison of images showing diseases with images showing no abnormalities could help them learn to discriminate relevant, disease-related information. Medical students studied 12 diseases on che...
We describe a 2 ½ year old boy presenting with fever, abdominal pain and splinter haemorrhages of the nails. On further examination there were signs of pneumonia with pleural effusion. This was treated with mini-thoracotomy, drainage and intravenous antibiotics. Further diagnostic workup for underlying causes showed diffuse cystic lung disease, sug...
A six day old male neonate, born after attempted external version (ECV) and vaginal breech birth, was evaluated for pain during diaper changes. US of the leg showed a small subperiosteal fluid collection at the distal right femur. Conventional radiographs demonstrated the presence of a classic metaphyseal corner fracture (CML). This case is to our...
Children differ from adults with respect to anatomical, physiological and psychological response to disease. Moreover, children can have a variety of congenital and hereditary disorders. Therefore radiologists who deal with children require specific knowledge and specific skills.
Children are not small adults. There are significant anatomical, physiological and psychological differences, and a large number of congenital and hereditary diseases can also be added to the list of differences.
Models of expertise differences in radiology often do not take into account visual differences between diseases. This study investigates the bottom-up effects of three types of images on viewing patterns of students, residents and radiologists: focal diseases (localized abnormality), diffuse diseases (distributed abnormality) and images showing no...
Previous studies examining reproductive parameters in men with galactosemia have inconsistently demonstrated abnormalities. We hypothesized that men with galactosemia may demonstrate evidence of reproductive dysfunction. Pubertal history, physical examination, hormone levels and semen analyses were examined in 26 males with galactosemia and compare...
We report a case of lumbar kyphosis due to fused vertebra with 2D and 3D images. A routine scan at 16 weeks showed lumbar kyphosis (L1–2). Amniocentesis revealed a normal female karyotype, 46, XX and normal alfafoetoprotein (3.9 μg/ ml)). At 20 weeks the kyphosis was stable and on 2D ultrasound the conus medullaris ended at L 2, without suspicion f...
FSH inactivity due to secondary hypoglycosylation has been suggested as a potential mechanism for primary ovarian insufficiency in classic galactosemia. To investigate the role of FSH and to gain insight in the timing of the damage, ovarian stimulation tests were performed and data on ovarian imaging collected. Fifteen patients with primary ovarian...
To re-evaluate gonad shielding in paediatric pelvic radiography in terms of attainable radiation risk reduction and associated loss of diagnostic information.
A study on patient dose and the quality of gonad shielding was performed retrospectively using 500 pelvic radiographs of children from 0 to 15 years old. In a subsequent study, 195 radiograph...
Nissen fundoplication is an effective treatment for gastro-esophageal reflux disease (GERD). Mobilization of the gastric fundus during fundoplication requires division of short gastric vessels of the spleen, which may cause splenic ischemia. The aim of this study was to determine if Nissen fundoplication results in hypotrophy of the spleen.
We perf...
On the fifth day of life, a 26-week male infant developed progressive abdominal and scrotal distension. Whitish discoloration of the scrotal skin raised suspicion of extravasation of lipid-containing parenteral nutrition solution (total parenteral nutrition (TPN)). A contrast study through the umbilical venous catheter (UVC) confirmed vessel perfor...
The incidence and prevalence of child abuse is unknown. The reason for this is that in nearly every study to establish the
incidence and prevalence, researchers use their own definition. Sometimes this is a ‘broad definition,’ such as that of the
World Health Organisation (WHO): ‘Child abuse, sometimes referred to as child abuse and neglect, includ...
Non-accidental fractures in children are signs of the application of severe external force. Hence, when non-accidental fractures
are present, it is essential that they are identified as soon as possible.
Fractures inflicted by violence can be found throughout the whole skeleton, are often present in multiples and may be in various
stages of healin...
Our goal was to validate the hypothesis that the lumbosacral angle (LSA) increases in children with spinal dysraphism who present with progressive symptoms and signs of tethered cord syndrome (TCS), and if so, to determine for which different types and/or levels the LSA would be a valid indicator of progressive TCS. Moreover, we studied the influen...
Imaging plays a major role in the diagnostic work-up of children with hepatobiliary or pancreatic diseases. It consists mainly of US, CT and MRI, with US and MRI being the preferred imaging modalities because of the lack of ionizing radiation. In this review the technique of US, CT and MRI in children will be addressed, followed by a comprehensive...
Robroeks CMHHT, Roozeboom MH, de Jong PA, Tiddens HAWM, Jöbsis Q, Hendriks HJ, Yntema J‐BL, Brackel HL, van Gent R, Robben S, Dompeling E. Structural lung changes, lung function, and non‐invasive inflammatory markers in cystic fibrosis.
Pediatr Allergy Immunol 2010: 21: 493–500.
© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard
Cys...
Although in the differential diagnosis of fractures sustained in childhood one should be particularly aware of accidental
trauma, it was found that congenital and acquired defects regularly give rise to suspicions of child abuse (see Table 7.1).
Based on a combination of patient history, laboratory tests and radiological examination, it is usually...
In his original publication from 1962 on ‘The battered child syndrome’, Kempe calls the child’s arms and legs the handles
used to inflict trauma [1]. This may lead to fractures, in particular of the long bones. However, in mobile children fractures
of arms and legs are also frequently caused by accidents. Depending on the force of the impact, speci...
In children fractures are a regular occurring feature (see section 1.2). When a physician finds a fracture in a child, he
can draw up a comprehensive differential diagnosis. In this chapter accidental childhood fractures are discussed.
The acute abdomen is a common and often challenging emergency in the pediatric population. This chapter provides an approach
to the imaging evaluation of children, highlighting briefly the more common causes of abdominal pain that may require surgery.
Ultrasonography (US) is the imaging modality of choice for the initial evaluation of diseases in children for many reasons.
First, it is relatively inexpensive and patient friendly. Second, it lacks radiation and motion artifacts. Third, the small
size of the child compensates for the limited penetration of sound waves and facilitates the use of hi...
Fractures are a common finding in children and it is estimated that 2.1% of all children will suffer at least one fracture before the age of 16. With young children in particular, the question may arise if this is related to child abuse. The aim of this book is to help physicians involved in child abuse cases to interpret radiological findings in l...
Even before Kempe published his now classic article on ‘the battered child syndrome’ in 1962 [1], radiologists drew attention
to fractures that could really only be explained by the impact of external mechanical force. In 1946, Caffey was the first
to describe the relation between the presence of multiple fractures of the long bones and subdural ha...
The clavicle is situated at the front-/upper side of the ribcage, between the shoulder girdle and the sternum. For the greater
part its course is clearly visible, just underneath the skin, and easily palpable along its full length. Fractures of the
clavicle are amongst the most frequently found fractures, in children as well as in adults. In childr...
This chapter addresses the role of imaging in the diagnosis of various “trivial” infectious diseases in childhood, including
cellulitis, subcutaneous abscess, necrotizing fasciitis, pyomyositis, infectious bursitis and arthritis, osteomyelitis, foreign
bodies, infectious lymphadenitis, as well as some “peculiar” pediatric infectious diseases.
Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature.
We present three neonates with both po...