[Case of vertical nystagmus due to compression].
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DICOM is today's de-facto standard for exchanging medical images. Since new image acquisition devices produce more and more image and non-image data, image compression has become an important part of the standard. However, the compression of non-pixel data also stored in DICOM data sets has been disregarded up to now. In the scope of an EU research project we have examined a large amount of real-world DICOM images to test whether or not there is a potential for compressing the non-pixel attributes. Especially for use with narrow-band networks extensions as proposed in this paper could be a solution to save valuable bandwidth.
Wavelet-based methods have become most popular for the compression of two-dimensional medical images and sequences. The standard implementations consider data sizes that are powers of two. There is also a large body of literature treating issues such as the choice of the "optimal" wavelets and the performance comparison of competing algorithms. With the advent of telemedicine, there is a strong incentive to extend these techniques to higher dimensional data such as dynamic three-dimensional (3-D) echocardiography [four-dimensional (4-D) datasets]. One of the practical difficulties is that the size of this data is often not a multiple of a power of two, which can lead to increased computational complexity and impaired compression power. Our contribution in this paper is to present a genuine 4-D extension of the well-known zerotree algorithm for arbitrarily sized data. The key component of our method is a one-dimensional wavelet algorithm that can handle arbitrarily sized input signals. The method uses a pair of symmetric/antisymmetric wavelets (10/6) together with some appropriate midpoint symmetry boundary conditions that reduce border artifacts. The zerotree structure is also adapted so that it can accommodate noneven data splitting. We have applied our method to the compression of real 3-D dynamic sequences from clinical cardiac ultrasound examinations. Our new algorithm compares very favorably with other more ad hoc adaptations (image extension and tiling) of the standard powers-of-two methods, in terms of both compression performance and computational cost. It is vastly superior to slice-by-slice wavelet encoding. This was seen not only in numerical image quality parameters but also in expert ratings, where significant improvement using the new approach could be documented. Our validation experiments show that one can safely compress 4-D data sets at ratios of 128:1 without compromising the diagnostic value of the images. We also display some more extreme compression results at ratios of 2000:1 where some key diagnostically relevant key features are preserved.
The potential advantages of digital computer processing of exercise electrocardiographic data include reduction of noise, compression of data, improved precision and application of optimal criteria. Most prior approaches to such processing required equipment that was both expensive and inconvenient. With the revolution in instrumentation brought about by the development of microcomputers, powerful dedicated computers can now be afforded by many exercise laboratories. There are many approaches to computerized management of exercise electrocardiographic data and various criteria for ischemia. Studies are necessary to validate computer algorithms so that these devices can be used diagnostically to best advantage. Cardiologists need some understanding of this field so that they can be discriminating users of computer systems. In addition, the results of studies correlating electrocardiographic changes with radionuclide methods of assessing myocardial perfusion and function should enable such assessments to be made from the electrocardiographic signals alone, particularly when aided by computer analysis of spatial shifts.
STUDY DESIGN: A human cadaveric study on the compressive strength of different lumbar interbody fusion implants and endplate preparation techniques was performed. OBJECTIVES: To assess the axial compressive strength of an implant with peripheral endplate contact as opposed to full surface contact, and to assess whether removal of the central bony endplate affects the axial compressive strength. SUMMARY OF BACKGROUND DATA: The compressive strength of interbody fusion constructs has been compared between implants and bone grafts. Neither implant design nor endplate preparation has been shown to affect strength. Removal of the central bony endplate for bone grafts was noted to improve graft incorporation but also to facilitate subsidence. METHODS: A total of 44 vertebrae were tested in four experimental groups by combining two interbody implants (full-surface vs peripheral surface support) with two endplate preparation techniques (intact bony endplate vs removal of the central bony endplate). Specimens were tested to ultimate compressive failure using a 50 N/second ramped load. Yield strength and ultimate compressive strength were compared between groups using two-factor analysis of covariance. A P value less than 0.05 was considered significant. Stepwise linear regressions assessed the predictive power of age, bone mineral content, and the implant's normalized endplate coverage on yield strength and ultimate compressive strength. RESULTS: Neither implant design nor endplate preparation technique affected yield strength or ultimate compressive strength. Age, bone mineral content, and the normalized endplate coverage were strong predictors of yield strength (P < 0. 0001; r2 = 0.459) and ultimate compressive strength (P < 0.0001; r2 = 0.510). CONCLUSIONS: An implant with only peripheral support resting on the apophyseal ring offers axial mechanical strength similar to that of an implant with full support. Neither supplementary struts nor a solid implant face has any additional mechanical advantage, but reduces graft-host contact area. Removal of the central bony endplate is recommended because it does not affect the compressive strength and promotes graft incorporation.
STUDY DESIGN: An in vivo study of the toxic consequences of static compressive stress on the intervertebral disc. OBJECTIVES: To determine whether disc cell death is correlated with the magnitude and duration of spinal compressive loading. SUMMARY OF BACKGROUND DATA: Static compression in vivo has been demonstrated to induce cell death. Cell death, in turn, has been associated with disc degeneration in humans. There are currently no tolerance criteria for the intervertebral disc that combine both biomechanical and biologic factors, although both have been implicated in cases of accelerated degeneration. METHODS: Mouse tail discs were loaded in vivo with an external compression device. Compressive stress was applied at one of two magnitudes (0.4 and 0.8 MPa) for 7 days, and at one additional magnitude (1.3 MPa) for 1, 3, and 7 days. Midsagittal sections of the discs were stained for apoptosis using the TdT-dUTP terminal nick-end labeling (TUNEL) reaction. Quantal analysis was used to correlate the extent of cell death to the magnitude and duration of loading. RESULTS: The probit transformation of the percentage of dying cells was proportional to the sum of the logarithmic transformations of the compressive stress and the time of loading. CONCLUSIONS: The results of this study demonstrate the feasibility of developing a quantitative correlation between spinal loading and disc degeneration. Such a correlation may be coupled in the future to existing engineering models that predict spinal loading in response to physical exposures and lead to improved definition of the bounds of healthy and unhealthy spinal loading, and ultimately, refined guidelines for low back safety.
STUDY DESIGN: A micro-computed tomography (CT) study of the trabecular bone structure on loaded mice tail vertebral bodies was conducted. OBJECTIVE: To depict and characterize changes in the trabecular bone structure of mice tail vertebral bodies after in vivo application of static compressive load. SUMMARY OF BACKGROUND DATA: Static compressive loading leads to significant structural changes in murine tail intervertebral discs, such as disorganization of the anulus fibrosus, increase in apoptosis, and associated loss of cellularity. Wolff's Law suggests that alterations in spinal loading will also influence the architecture of the adjacent vertebral bodies. Because of biomechanical and biologic interdependencies between the disc and vertebra, these tissues should be considered simultaneously when investigating the etiology of degenerative spinal conditions. METHODS: Mice tail discs between the ninth and 10th caudal vertebrae were compressed in vivo for 7 days with static axial loads using external fixators. Micro-CT scans of the vertebral bodies were performed at an isotropic resolution of 18 microm, to obtain trabecular bone structural parameters. Random effects models were used to evaluate statistical significance of these parameters in different compressed conditions. RESULTS: With loading, the connectivity density of the trabecular network increases significantly. After a period of in vivo recovery on load removal, the trabeculae become more rod-like; corresponding changes such as disorganization of the anulus fibrosus and loss of nuclear and inner-anular cellularity are also seen. CONCLUSIONS: In vivo compressive loading leads to significant architectural changes within vertebral bodies. These observations may be helpful in understanding the pathologic processes and the chronology of degenerative spinal conditions.
Image compression is broadly categorized as lossless or lossy. With lossless compression, a compressed image can be decompressed and displayed as an exact digital replica of the original. With lossy compression, redundant pixel data are discarded during the compression process so that the compressed image is only an approximation of the original, therefore it cannot be returned to an original state. Although both types of compression are commonly used within the medical imaging community, institutions are much more likely to depend upon lossless compression for diagnostic purposes, even though lossy images, saved as a fraction of the original file size, are often diagnostically equivalent. With more and more digital modalities coming online and image studies growing ever larger, institutions failing to take full advantage of lossy compression are missing an opportunity to slow the growth of their image archives and IT infrastructure costs. Today, most PACS vendors include some form of image compression technology within their product offerings. Of 13 vendors sampled during an informal survey in June 2003, eight employ JPEG 2000 compression, which was incorporated into the DICOM standard in 2001, while the remainder use wavelet compression, which is the underlying methodology used in JPEG 2000. JPEG 2000 is an industry standard that enables image sharing across platforms and product lines. It also provides a single mechanism for creating lossless and lossy images, and gives institutions the flexibility to apply unique rates of compression to individual images based on modality, patient history, image size or other factors. Although it can be used judificiously to great advantage, compression is most often applied in an "across the board" manner to all images. The incorporation of JPEG 2000 within the DICOM standard does little to guarantee its longevity, or the quality of every JPEG 2000 implementation. At some point in time, especially as the demand for more compact, higher-quality lossy images grows, institutions will begin experimenting with and employing more advanced compression methods.
OBJECTIVES: To review the literature on lossy compression in dental radiography and to discuss the importance and suitability of the methodology used for evaluation of image compression. METHODS: A search of Medline (from 1966 to October 2004) was undertaken with the search expression "(Radiography, dental) and compression". Inclusion criterion was that the reference should be evaluating the effect of lossy image compression on diagnostic accuracy. For all included studies, information in relation to mode of image acquisition, image content, image compression, image display, and method of image evaluation was extracted. RESULTS: 12 out of 32 papers were included in the review. The design of these 12 studies was found to vary considerably. Parameters used to express the degree of information loss (DIL) were either or both compression ratio (CR) and compression level (CL). The highest acceptable CR reported in the studies ranged from 3.6% to 15.4%. Furthermore, different CR values were proposed even for the same diagnostic task, for example, for caries diagnosis CR ranged from 6.2% to 11.1%. CONCLUSION: Lossy image compression can be used in clinical radiology if it does not conflict with national law. However, the acceptable DIL is difficult to express and standardize. CR is probably not suitable to express DIL, because it is image content dependent. CL is also probably not suitable to express DIL because of the lack of compression software standardization.
This study aims to compare the integrity and reproducibility of measurements created from uncompressed and compressed digital images in order to implement compliance with 21 CFR Part 11 for image analysis studies executed using 21 CFR Part 58 compliant capture systems. Images of a 400-mesh electron microscope grid and H&E stained rat liver tissue were captured on an upright microscope with digital camera using commercially available analysis software. Digital images were stored as either uncompressed TIFFs or in one of five different levels of JPEG compression. The grid images were analyzed with automatic detection of bright objects while the liver images were segmented using color cube-based morphometry techniques, respectively, using commercially-available image analysis software. When comparing the feature-extracted measurements from the TIFF uncompressed to the JPEG compressed images, the data suggest that JPEG compression does not alter the accuracy or reliability to reproduce individual data point measurements in all but the highest compression levels. There is, however, discordance if the initial measure was obtained with a TIFF format and subsequently saved as one of the JPEG levels, suggesting that the use of compression must precede feature extraction. It is a common practice in software packages to work with TIFF uncompressed images. However, this study suggests that the use of JPEG compression as part of the analysis work flow was an acceptable practice for these images and features. Investigators applying image file compression to other organ images will need to validate the utility of image compression in their work flow. A procedure to digitally acquire and JPEG compress images prior to image analysis has the potential to reduce file archiving demands without compromising reproducibility of data.
STUDY DESIGN: Edema in the dorsal nerve roots caused by acute compression was assessed quantitatively in the lumbar spine of the adult dog. OBJECTIVE: To establish quantitative evaluation of edema in the dorsal nerve roots and to observe changes after acute compression with time. SUMMARY OF BACKGROUND DATA: Mechanical compression induces an increase in microvascular permeability of the endoneurial capillaries and results in intraneural edema. However, there are no quantitative studies on edema in the nerve roots. METHODS: The seventh lumbar nerve root was compressed with a 60-g force clip for 10 minutes. The nerve roots were removed immediately and at 24 hours, 1 week, and 3 weeks after compression. Nerve roots from the control and the sham groups were also obtained. Before removing the nerve roots, Evans blue albumin was injected intravenously. Changes in edema were examined using fluorescence microscopy. Evans blue albumin emits a bright red fluorescence. The relative red fluorescent area was calculated using computer image analysis, and the data were used to indicate the degree of edema. RESULTS: In the compressed segment, edema was most pronounced just after decompression and reduced in nerves removed at 24 hours. In nerves removed at 1 week, edema was pronounced but was reduced at 3 weeks. In the segments closest to the spinal cord, edema was seen after 1 week and was significant after 3 weeks. In the segments closest to the dorsal root ganglion, edema was not detected at any time. CONCLUSION: In the dorsal nerve roots the degree and the area of edema changed with time elapsed after acute compression. The degree of edema 24 hours after decompression was one third the degree immediately after decompression. These results show that edema induced by mechanical compression can recover after decompression.
This study has shown the importance of relating NMR spectroscopic information on the water in model food structures to the mechanical properties of those structures. Analysis of the NMR relaxation data can be used to examine the distribution of water domain sizes, and this has been related to the mechanical properties of the samples. A novel NMR probe-head has been designed, which allows both the NMR and the mechanical data to be simultaneously measured during compression of the sample. This probe-head allows compressive stress/strain data to be obtained directly from the NMR sample, allowing changes in the distribution of the water to be directly correlated to changes in mechanical properties.