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PubMedDate not supplied

The effects of compressive load and knee joint torque on peak anterior cruciate ligament strains.

BACKGROUND: High graft strains incurred during rehabilitation after anterior cruciate ligament reconstruction may be minimized if an external compressive load is simultaneously applied to the joint during closed kinetic chain exercises. HYPOTHESES: Peak anterior cruciate ligament strains will 1). increase with an increase in resistance torque during an exercise that involves concentric contraction of the extensor mechanism, 2). decrease with an increase in resistance torque during an exercise that involves concentric contraction of the flexors, and 3). decrease when an external compressive load is applied to the knee during both exercises relative to the no external compressive load condition. STUDY DESIGN: Controlled laboratory study. METHODS: Strains in the anteromedial bundle were measured in 10 subjects with normal ligaments. Flexor and extensor exercises were performed against controlled resistance torques with and without a compressive load applied to the foot. RESULTS: An increase in resistance produced an increase in peak anterior cruciate ligament strain for the extensor exercise with no compressive load applied. During the flexor exercise without a compressive load, an increase in resistance produced a decrease in peak strains. During the extensor exercise, the peak anterior cruciate ligament strain was not reduced with the application of the external compressive force. CONCLUSIONS: Extensor and flexor exercises that incorporate an external compressive load do not shield the anterior cruciate ligament from strain. However, no additional increase in strain occurs with an increase in resistance when the external compressive load is applied. Thus, it may be possible to increase the activity of the quadriceps muscles without increasing the strain by applying a compressive load (as with closed kinetic chain exercises).

Adult↗

PubMed1995

Mechanical compression modulates matrix biosynthesis in chondrocyte/agarose culture.

This study focuses on the effect of static and dynamic mechanical compression on the biosynthetic activity of chondrocytes cultured within agarose gel. Chondrocyte/agarose disks (3 mm diameter) were placed between impermeable platens and subjected to uniaxial unconfined compression at various times in culture (2-43 days). [35S]sulfate and [3H]proline radiolabel incorporation were used as measures of proteoglycan and protein synthesis, respectively. Graded levels of static compression (up to 50%) produced little or no change in biosynthesis at very early times, but resulted in significant decreases in synthesis with increasing compression amplitude at later times in culture; the latter observation was qualitatively similar to that seen in intact cartilage explants. Dynamic compression of approximately 3% dynamic strain amplitude (approximately equal to 30 microns displacement amplitude) at 0.01-1.0 Hz, superimposed on a static offset compression, stimulated radiolabel incorporation by an amount that increased with time in culture prior to loading as more matrix was deposited around and near the cells. This stimulation was also similar to that observed in cartilage explants. The presence of greater matrix content at later times in culture also created differences in biosynthetic response at the center versus near the periphery of the 3 mm chondrocyte/agarose disks. The fact that chondrocyte response to static compression was significantly affected by the presence or absence of matrix, as were the physical properties of the disks, suggested that cell-matrix interactions (e.g. mechanical and/or receptor mediated) and extracellular physicochemical effects (increased [Na+], reduced pH) may be more important than matrix-independent cell deformation and transport limitations in determining the biosynthetic response to static compression. For dynamic compression, fluid flow, streaming potentials, and cell-matrix interactions appeared to be more significant as stimuli than the small increase in fluid pressure, altered molecular transport, and matrix-independent cell deformation. The qualitative similarity in the biosynthetic response to mechanical compression of chondrocytes cultured in agarose gel and chondrocytes in intact cartilage further indicates that gel culture preserves certain physiological features of chondrocyte behavior and can be used to investigate chondrocyte response to physical and chemical stimuli in a controlled manner.

Animals↗

PubMed1998

Mechanical compression alters proteoglycan deposition and matrix deformation around individual cells in cartilage explants.

We have used new techniques of cell-length scale quantitative autoradiography to assess matrix synthesis, deposition, and deformation around individual chondrocytes in mechanically compressed cartilage explants. Our objectives were to: (1) quantify the effects of static and dynamic compression on the deposition of newly synthesized proteoglycans into cell-associated and further-removed matrices; (2) measure cell-length scale matrix strains and morphological changes of the cell and matrix associated with tissue compression; and (3) relate microscopic physical stimuli to changes in proteoglycan synthesis as functions of compression level and position within mechanically compressed explants. Results indicate a high degree of structural organization in the extracellular matrix, with the pericellular matrix associated with the most rapid rates of proteoglycan deposition, and greatest sensitivity to mechanical compression. Static compression could stimulate directional deposition of secreted proteoglycans around chondrocytes, superimposed on an inhibition of proteoglycan synthesis; these events followed trends for compressive strain in the cell-associated matrix. Conversely, proteoglycan synthesis and pericellular deposition was stimulated by dynamic compression. Results suggest that cell-matrix interactions in the cell-associated matrix may be a particularly important aspect of the chondrocyte response to mechanical compression, possibly involving macromolecular transport limitations and morphological changes associated with fluid flow and local compaction of the matrix around cells.

Animals↗

PubMed2004

The impact of image compression on diagnostic quality of digital images for detection of chemically-induced periapical lesions.

OBJECTIVES: To test the hypothesis that there is no significant difference in the detectability of chemically-induced periapical lesions between a non-compressed image and one subjected to a Joint Photographic Experts Group (JPEG) lossy compression technique at a ratio of 23:1 or less. METHOD: Chemically-induced periapical lesions were created by placing a solution of 70% perchloric acid at the apex of extracted teeth in 13 human jaw cadaver specimens. Acid was applied in seven incremental time periods from 0-32 h. Extracted teeth were replaced in the socket and images were made using the Schick CDR digital sensor. Using a JPEG lossy compression algorithm, five compression ratios of 2:1, 14:1, 23:1, 28:1 and 47:1 were applied to the images. Images were viewed three times by three observers who ranked the presence or absence of a lesion at three sites, the mesial area, distal area and apex of the tooth, on a 5-point confidence scale. Intraobserver and interobserver agreement and agreement between the compressed and the original images were assessed with intraclass correlation coefficients (ICCs). RESULTS: Overall ICCs for measuring intraobserver agreement using all images were 0.77, 0.84, and 0.50 for the three observers, respectively. The overall ICC for assessing agreement between observers was 0.57. There was no significant difference (P>0.05) between compressed and original images for any site at compression ratios of 2:1, 23:1 and 28:1. There were significant differences for a compression ratio of 47:1. CONCLUSION: JPEG compression does not impact detectability of artificial periapical lesions at low and moderate compression ratios up to and including 28:1.

Algorithms↗

PubMed2005

Compression and peri-ulcer skin in outpatients' venous leg ulcers: results of a French survey.

OBJECTIVE: To evaluate concordance with compression therapy in ambulatory patients with venous leg ulcers. METHOD: This was a prospective observational survey conducted in general practice. Consecutive patients with venous leg ulcers about to receive a non-adherent primary dressing and with no contraindication to compression bandaging were selected. At the inclusion visit, size, local aspect of the ulcer and the peri-ulcer skin were scored. Patients were asked about concordance with compression and were given a questionnaire to be completed at home. If patients were seen at a three-week follow-up visit, ulcer and peri-ulcer characteristics and concordance were reassessed. RESULTS: A total of 2842 patients were included, of whom 2532 were re-evaluated at three weeks and 1397 (49%) returned their questionnaire. A compression bandage was already available for 62.9% of these patients, and 62.7% said they used it on a daily basis, 23.3% wore it one or two days per week and 13.7% wore it irregularly or never. There was a statistically significant correlation between concordance with compression and ulcer and peri-ulcer skin severity scores (p < 0.001 and p = 0.042 respectively). At the follow-up visit, concordance with compression therapy improved (80.1% were wearing it regularly). Ulcer, peri-ulcer skin severity scores and ulcer size were significantly lower (p < 0.001) when concordance with compression therapy was good. However, 65.6% of patients considered applying compression very difficult; 45% considered it very unaesthetic and 23% judge wearing it to be very painful, while 9% thought it may worsen their ulcer. CONCLUSION: On a short-term basis, concordance with compression can be substantially improved by simple measures with a clear favourable consequence on both ulcer status and peri-ulcer skin aspect when a non-adherent primary dressing is used. However, the acceptability of compression to patients is poor, and continuous effort is required to convince them of its importance.

Adolescent↗

PubMed1987

Radiological image compression using error-free irreversible two-dimensional direct-cosine-transform coding techniques.

Some error-free and irreversible two-dimensional direct-cosine-transform (2D-DCT) coding, image-compression techniques applied to radiological images are discussed in this paper. Run-length coding and Huffman coding are described, and examples are given for error-free image compression. In the case of irreversible 2D-DCT coding, the block-quantization technique and the full-frame bit-allocation (FFBA) technique are described. Error-free image compression can achieve a compression ratio from 2:1 to 3:1, whereas the irreversible 2D-DCT coding compression technique can, in general, achieve a much higher acceptable compression ratio. The currently available block-quantization hardware may lead to visible block artifacts at certain compression ratios, but FFBA may be employed with the same or higher compression ratios without generating such artifacts. An even higher compression ratio can be achieved if the image is compressed by using first FFBA and then Huffman coding. The disadvantages of FFBA are that it is sensitive to sharp edges and no hardware is available. This paper also describes the design of the FFBA technique.

Angiography↗

PubMed2005

Operator-dependent techniques for graded compression sonography to detect the appendix and diagnose acute appendicitis.

OBJECTIVE: The objective of our prospective study was to evaluate the value of various operator-dependent techniques that allow graded compression sonography to detect normal or abnormal vermiform appendix. SUBJECTS AND METHODS: A total of 877 subjects were included in this study. This sample population consisted of two groups: 202 control subjects and 675 patients who were suspected of having acute appendicitis. If detection of the appendix failed after a sufficient number of trials using graded compression scanning, appropriate operator-dependent techniques were used to help graded compression scanning to increase the detectability of the appendix further. The detection rate for the appendix in both groups and the diagnostic accuracy for acute appendicitis were obtained. RESULTS: The initial graded compression sonography examination depicted the appendix in 170 (84%) of 202 subjects in the control group and 601 (89%) of the 675 patients in the patient group. We then added operator-dependent techniques to graded compression sonography for the remaining patients in whom the appendix could not be detected. The additional use of the posterior manual compression technique, low-frequency convex transducer, upward graded compression technique, or left oblique lateral decubitus change of body position allowed graded compression sonography to depict the appendix in an additional 10, eight, six, and four patients in the control group, respectively, and in an additional 27, 23, 11, and seven patients in the patient group. The number of identified appendixes was increased to 198 (98%) of the 202 patients in the control group and to 669 (99%) of the 675 patients in the patient group. Graded compression sonography with operator-dependent techniques in the patient group yielded a sensitivity of 99% (319/321 patients), specificity of 99% (350/354), and an accuracy of 99% (669/675) for acute appendicitis. CONCLUSION: The addition of various operator-dependent techniques to graded compression sonography is useful for allowing improved visualization of both normal and abnormal appendixes.

Acute Disease↗

PubMed1985

Changes in contralateral brain-stem auditory evoked responses to cerebellopontine angle compression in rats.

Eleven rats were subjected to graded compression of the brain stem at the cerebellopontine angle (CPA) following craniectomy and cerebellectomy. Clicks were delivered to the ear contralateral to the compression site, and brain-stem auditory evoked responses (BAER's) were collected before and during compression. With increasing compression, there was an increase in the latency and a decrease in the amplitude of the peaks of the BAER. The later peaks of the BAER (V and VI) demonstrated changes with minimal compression that progressed as compression increased, while changes in the amplitude and latency of the earlier peaks (II, III, and IV) occurred at the higher grades of compression. Following decompression of the brain stem, there was a decrease in the latencies of most of the BAER peaks. Peak amplitude remained depressed following brain-stem decompression. These experimental findings corroborate clinical reports of abnormal BAER's elicited from stimulation of the ear contralateral to a CPA tumor. The relative sensitivity of the later peaks of the BAER to even minimal brain-stem compression explains the prolonged III to V interpeak latency reported in the literature in patients with brain-stem compression from a CPA lesion. The possible mechanisms for the BAER changes that were observed contralateral to compression are discussed.

Animals↗

PubMedDate not supplied

Incidence of corneal epithelial defects with the standard and zero-compression hansatome microkeratomes.

PURPOSE: To evaluate the incidence of epithelial defects in patients who have had laser in situ keratomileusis (LASIK) surgery with the standard compression Hansatome microkeratome head in comparison to the modified (zero-compression) Hansatome microkeratome head (Bausch & Lomb, Rochester, NY). METHODS: This study was a retrospective review of 404 consecutive patients who had LASIK surgery on both eyes between January 2002 and June 2002. The standard compression microkeratome head was used in 216 (53%) cases and the zero-compression microkeratome head was used in 188 (47%) cases. Epithelial defects were categorized as loose epithelium, or a break in the epithelium, within the area of the flap. An adverse outcome for a patient was defined as having an epithelial defect in at least one eye. Odds ratios were estimated using logistic regression. RESULTS: When the standard compression microkeratome head was used, 19 (8.8%) patients had an epithelial defect in at least 1 eye. When the zero-compression microkeratome head was used, 5 (2.7%) patients had an epithelial defect in at least 1 eye. Logistic regression comparing the risk of epithelial defect in either eye with the standard compression head versus the zero-compression head resulted in an age-adjusted odds ratio of 0.2 (95% confidence interval, 0.07 to 0.58, P < .05). CONCLUSIONS: These findings provide evidence that LASIK surgery with a zero-compression head reduces the risk of epithelial defect compared to the standard compression head of the Hansatome microkeratome.

Adult↗

PubMed2003

[Formation of compressive bandage after sclerotherapy for lower limb varices].

Invention concerns compressive sclerotherapy as a treatment modality for lower limb varices. Technical result of investigation is the development of compressive bandage that creates and maintains adequate level of limb compression both in supine position (during bed rest) and standing or walking. Technical result is achieved by formation of two compressive layers of elastic bandage. Highly expansible elastic bandage is used for the first layer aimed for fixation and compression of latex or foam pads at injection sites to create local compression of variceal nodes. Open toe elastic stocking (I compression class) is placed over the bandage to maintain adequate compression during bed rest. The second external layer consists of elastic bandage with moderate expansion (II compression class). It is placed over the first one from toes to thigh upper third and creates optimal compression in patient's vertical position. The patient is permitted to take it off or loose exclusively in supine position, to wash or refresh foot with wet towel, to change it with a new one.

Bandages↗

PubMed2006

Studies on the compressibility of wax matrix granules of acetaminophen and their admixtures with various tableting bases.

Matrix granules of acetaminophen have been formed by a melt granulation process whereby the acetaminophen powder was triturated with the melted wax--goat wax, glyceryl monostearate or carnuba wax. The compressibility of the matrix granules and their admixture, with diluent granules (lactose, alpha-cellulose or microcrystalline cellulose) was investigated. The granules were compressed to tablets at a constant load (30 arbitrary units on the load scale) of a manesty single punch machine. Resulting tablets were evaluated for tensile strength (T) and disintegration times (DT). Granule flow was determined by measuring their angle of repose when allowed to fall freely on a level surface. Matrix granules prepared by melt granulation with goat wax or glyceryl monostearate were too sticky and therefore did not flow at all. They were also poorly compressible (T values = 0.20MN/m2). Inclusion of the diluent remarkably improved granule flow property and compressibility. The T values of the tablets (measure of compressibility) increased from about 0.24 to 0.65 MN/m2 during increase in diluent (lactose) content from 20 to 80 %w/w. Microcrystalline cellulose and alpha-cellulose were more effective than lactose in promoting compressibility of the granules. By contrast the matrix granules formed with carnuba wax were free flowing (angle of repose, 18.60). Addition of the diluent further improved flowability slightly. The matrix granules (without a diluent) were readily compressible (T value, 1.79MN/m2). Addition of the diluent (80%w/w) reduced T values (MN/m2) slightly to 1.32 (lactose), 1.48 (alpha-cellulose) and 1.74 (microcrystalline cellulose). Tablets of the matrix granules only, disintegrated rapidly within 3 minutes. DT was further reduced to <30 s by addition of any of the diluents. The indication is that the inclusion of the diluents studied can be used to improve the compressibility of the otherwise poorly compressible matrix granules. Based on the flowability, compressibility, and disintegration data, carnuba wax proved most promising in the melt granulation of the test drug for sustained release applications.

Acetaminophen↗

PubMed1990

Surgery for benign thyroid disease causing tracheoesophageal compression.

Even though the incidence of multinodular goiter is decreasing in the United States, still we see a large number of neglected goiters causing pressure effects on the surrounding structures. Both tracheal and esophageal displacement cause compression symptoms. However, tracheal compression may lead to acute airway distress. Eighteen per cent of our patients presented with acute airway problems, requiring emergency admission or intubation. Surgical intervention has been our preferred approach whenever there are signs or symptoms of tracheoesophageal compression. Fifty-five per cent of patients had only tracheal compression, while 18 per cent had only esophageal compression. Twenty-seven per cent had compression of both trachea and esophagus. Eighty-five per cent of patients had some symptoms of compression, while only 15% were asymptomatic despite large goiters. Compression symptoms and acute problems were noticed more frequently in patients with substernal goiters. Our preoperative work-up regularly included complete history, physical examination, indirect laryngoscopy, and airway radiography. Barium studies were performed if patients had dysphagia. Computed tomography scans were utilized if there was mediastinal extension. Pulmonary flow volume studies were used to locate the site of compression. However, decisions relative to surgical intervention were based primarily on clinical judgment. Since the postoperative morbidity is minimal in surgery for thyroid abnormalities, we strongly recommend early surgical intervention in patients with tracheoesophageal compression caused by enlarged thyroids.

Adenoma↗

PubMed1995

Time to hemostasis: a comparison of manual versus mechanical compression of the femoral artery.

BACKGROUND: Compression of the femoral artery to achieve hemostasis is necessary following angiographic and interventional cardiovascular procedures. OBJECTIVES: To evaluate length of time to hemostasis with manual versus mechanical compression of the femoral artery. METHODS: In a prospective study of 503 patients randomized into one of three groups, manual compression with a pressure dressing or vascular stasis button was used on groups 1 and 3, respectively. Mechanical compression with a pressure dressing was used on group 2. The length of time to hemostasis was measured in minutes. Demographic data, current medications, risk factors, laboratory values, and procedural data were analyzed. RESULTS: Mean time to hemostasis was 22 minutes with manual compression and 31 minutes with mechanical compression. Crossover from mechanical to manual compression to achieve hemostasis occurred in 21 of 168 patients (13%). CONCLUSIONS: Results of this study show that advantages of manual compression include shorter time to hemostasis, no requirement for special equipment, and the ability to remove arterial and venous sheaths simultaneously. Disadvantages include upper extremity fatigue and human resource considerations. If the operator is a nurse, the cost of compression increases and the ability to meet patient needs may be restricted. Although mechanical compression is a "hands free" approach, arterial hemostasis is prolonged, special equipment is required, and the total cost per procedure is higher.

Analysis of Variance↗

PubMed1996

Ardeparin (low-molecular-weight heparin) vs graduated compression stockings for the prevention of venous thromboembolism. A randomized trial in patients undergoing knee surgery.

BACKGROUND: Deep vein thrombosis is common in patients undergoing major knee surgery. Static graduated compression stockings effectively prevent venous thrombosis in general surgery. Because of the demonstrated prophylactic efficacy of pneumatic compression in knee surgery, the similar efficacy of static graduated compression and pneumatic compression in neurosurgery, and the easier use of static graduated compression in knee surgery, graduated static compression stockings were used as the control arm in our clinical trial. Although low-molecular-weight heparin had been shown to be effective in general surgery and hip replacement, its efficacy was unproved in knee surgery. METHODS: A double-blind, randomized trial compared the combination of low-molecular-weight heparin and graduated compression stockings with graduated compression stockings alone in patients undergoing major knee surgery. Patients received either ardeparin (Normiflo) (low-molecular-weight heparin), 0.005 mL/kg (50 anti-Xa U/Kg), or placebo. Both were administered subcutaneously twice daily commencing 12 to 24 hours after surgery and continued for 14 days or until discharge, if sooner. Both study groups wore graduated compression stockings. Bilateral venography was performed on day 14, or sooner if the patient was ready for discharge. RESULTS: One hundred twenty-two patients were allocated to receive ardeparin and 124 received placebo. Ninety-six patients in the ardeparin group and 103 in the placebo group had evaluable venograms. Deep vein thrombosis was detected in 28 patients in the ardeparin group and in 60 in the placebo group. Proximal deep vein thrombosis was detected in two patients who received ardeparin and 16 who received placebo. One patient in each group, both of whom did not have venography, experienced pulmonary embolism. Thus, deep vein thrombosis or pulmonary embolism was detected in 29 (29.9%) of the 97 patients in the ardeparin group and in 61 (58.7%) of the 104 patients in the placebo group, a relative risk reduction of 49% (P < 00.1). The rate of major bleeding in the ardeparin group was 2.5%, compared with 2.4% in the placebo group. CONCLUSION: Ardeparin administered postoperatively twice daily is effective and safe for the prevention of venous thrombosis in patients undergoing major knee surgery. Whereas graduated compression stockings have been shown to be effective prophylactic agents in general surgery and neurosurgery, they have little effect in knee surgery.

Aged↗

PubMed2006

Purinergic pathway suppresses the release of .NO and stimulates proteoglycan synthesis in chondrocyte/agarose constructs subjected to dynamic compression.

Mechanical loading plays a fundamental role in the physiological and pathological processes of articular cartilage. The application of dynamic compression to chondrocytes cultured in agarose, downregulates the release of nitric oxide (NO) and enhances cell proliferation and proteoglycan synthesis. We hypothesize that the observed metabolic changes in response to dynamic compression involve a purinergic signaling pathway. Chondrocyte/agarose constructs were subjected to dynamic compression (15%, 1 Hz, 48 h) in the presence of antagonists for the purinergic pathway. Gadolinium was used as a putative inhibitor of stretch-activated calcium ion channels including adenosine 5'-triphosphate (ATP) release channels; suramin was employed as a P2 receptor antagonist and apyrase was used to catalyze the hydrolysis of extracellular ATP. The data presented demonstrate that in the absence of the inhibitor, dynamic compression suppressed .NO release. Treatment with gadolinium and suramin caused a compression-induced upregulation of .NO release, a response abolished with apyrase. Compression-induced stimulation of cell proliferation was reversed with gadolinium, suramin, or apyrase. By contrast, compression-induced stimulation of proteoglycan synthesis was abolished under all treatment conditions. Thus, the purinergic pathway is important in suppressing the release of .NO and stimulation of proteoglycan synthesis. Indeed, high levels of .NO could trigger a downstream catabolic response and mediate the compression-induced inhibition of cell proliferation. The current study demonstrates for the first time the importance of a purinergic pathway in mediating the metabolic response to dynamic compression and suppressing an inflammatory effect.

Adenosine Triphosphate↗

PubMed1986

Effects of nerve compression on fast axonal transport in streptozotocin-induced diabetes mellitus. An experimental study in the sciatic nerve of rats.

The hypothesis that nerves in diabetes mellitus exhibit an increased susceptibility to compression was experimentally tested. Inhibition of fast axonal transport was induced by local compression in sciatic nerves of rats with streptozotocin-induced diabetes mellitus. Fast anterograde axonal transport was measured after application of 3H-leucine to the motor neurone cell bodies in the spinal cord. The sciatic nerve was subjected to local, graded compression in vivo by a small compression chamber. The amount of accumulation of proteins was quantified by calculation of a transport block ratio. Compression at 30 mm Hg for 3 h induced a significantly greater (p less than 0.05) accumulation of axonally transported proteins at the site of compression in nerves of diabetic animals (transport block ratio: 1.01 +/- 0.35; n = 7) than in nerves of controls (0.67 +/- 0.16; n = 7). Accumulation was significantly higher in ligature experiments of both control (1.34 +/- 0.44; n = 8; p less than 0.01) and diabetic animals (1.45 +/- 0.30; n = 8; p less than 0.05), indicating that the block of transport in compressed nerves was incomplete. Neither sham compressed diabetic (0.50 +/- 0.09; n = 6) nor control (0.49 +/- 0.11; n = 6) nerves showed any block of axonal transport. The possible causes of the increased inhibition of fast axonal transport in diabetic rats are discussed. The results indicate that diabetes may lead to an increased susceptibility of peripheral nerves to compression.

Animals↗

PubMed1998

Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings.

The published rates of operatively confirmed neurovascular compression as the cause for trigeminal neuralgia range from 10% to nearly 100%. High-definition magnetic resonance angiography (MRA) was performed in 27 consecutive patients (in 6 cases with 3D reconstructions) to show neurovascular compression preoperatively. The MRA findings were compared with the relationship between the Vth nerve and the surrounding vessels at surgery. In 23 patients MRA showed present neurovascular compression in accordance with surgical findings (18/27 in complete accordance of type and side of vessel, site and direction of compression). One woman had no neurovascular compression either on MRA or intraoperatively. One MRA prediction of neurovascular compression was false, and two results were false negative. The sensitivity of MRA was therefore 88.5% but the specificity only 50%, if surgical findings are the reference. In one patient with right trigeminal neuralgia MRA revealed bilateral neurovascular compression of the Vth nerves. Therefore, the overall specificity of MRA might be below 50%. In one patient with multiple sclerosis, the decision to operate was markedly influenced by the clear finding of neurovascular compression on MRA. The patient has been free from trigeminal pain for 149 weeks after microvascular decompression. In 6 patients, 3D reconstructions of the MRA data were performed. The images helped in 3D visualisation of the operation, but did not yield new information about the nature of the vessels revealed, or the site, direction or side of the neurovascular compression.

Cerebellopontine Angle↗

PubMed2006

Computer-aided detection of solid lung nodules in lossy compressed multidetector computed tomography chest exams.

RATIONALE AND OBJECTIVES: To assess the effect of three-dimensional (3D) lossy image compression of multidetector computed tomography chest scans on computer-aided detection (CAD) of solid lung nodules greater than 4 mm in size. MATERIALS AND METHODS: A total of 120 cases, acquired with 1.25-mm collimation, were collected from 5 different sites, of which 66/120 were low-dose cases. Two chest radiologists established that 37 cases had no actionable lung nodules; the remaining 83 cases contained 169 nodules (range 3.8-35.0 mm, mean 5.8 mm +/- 3.0 [SD]). All cases were compressed using the 3D Set Partitioning in Hierarchical Trees algorithm to 24:1, 48:1, and 96:1 levels. A study of the effect of compression on computer-aided detection (CAD) sensitivity was performed at operating points of 2.5 false marks (FM), 5 FM, and 10 FM per case using McNemar's test. Logistic regression models were used to evaluate the impact on CAD sensitivity by compression level on nodule and image characteristics. RESULTS: Compared with no compression, there was no significant degradation in CAD sensitivity found at any of the studied compression levels and operating points. However, between compression levels, there was marginal association with sensitivity. Specifically, 24:1 level was significantly better than 96:1 at all operating points, and occasionally better than no compression at 10 FM/case. Based on multivariate analysis, nodule location was found to be a significant predictor (P = .01) with a lower sensitivity associated with juxtapleural nodules. Nodule size, dose, reconstruction filter, and contrast medium were not significant predictors. CONCLUSION: CAD detection performance of solid lung nodules did not suffer until 48:1 compression.

Algorithms↗