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PubMed2006

Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity.

The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the general concepts that should be known to evaluate the entrapment and compressive neuropathy in MR imaging. We also review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the lower extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the lower extremity are as follows: sciatic nerve around the piriformis muscle; tibial nerve at the popliteal fossa and tarsal tunnel, common peroneal nerve around the fibular neck, and digital nerve near the metatarsal head. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging.

Humans↗

PubMed1998

Expression of endothelial barrier antigen immunoreactivity in blood vessels following compression trauma to rat spinal cord. Temporal evolution and relation to the degree of the impact.

The endothelial barrier antigen (EBA) recognised by a monoclonal antibody is expressed in rat cerebral microvessels possessing blood-brain barrier properties but only weakly by fenestrated vessels. We have studied the expression of this marker in the spinal cord of control rats and compared the findings with those seen in rats subjected to compression injury at the T8-9 level with a survival period of 4 h, 24 h, 4 days and 9 days. To that end, formalin-fixed paraffin-embedded material was immunostained by the avidin-biotin-peroxidase complex method. Sections from control rats presented a distinct immunostaining at the site of the endothelial cells of almost all microvessels in the grey and white matter of the cord. The anterior and posterior spinal arteries did not show such staining. Neurons and glial cells were unstained. Rats which had survived 4 h after a moderate or severe compression trauma still showed immunoreactivity in intramedullary microvessels at the site of injury. There was a moderate reduction of vascular immunoreactivity at 24 h and a pronounced loss of such reactivity at 4 days after trauma. At 9 days after compression the expression of the endothelial barrier antigen had almost been normalised in the microvessels of the cord. In conclusion, using immunohistochemistry, EBA can be demonstrated in noninjured rat spinal cord microvessels, while the staining disappears at the site of compression trauma to the cord. The EBA marker can be used to indicate sites of vascular injury in spinal cord compression injury. The factors causing the disappearance and restitution of the antigen are unknown.

Animals↗

PubMed1998

The value of somatosensory and motor evoked evoked potentials in pre-clinical spondylotic cervical cord compression.

Previous studies have yielded conflicting data concerning the value of evoked potential parameters in the assessment of clinical relevance of cervical cord compression in clinically "silent" cases. The aim of this study was to assess the value of somatosensory (SEP) and motor evoked potentials (MEP) in the evaluation and prediction of the clinical course, by means of a 2-year follow-up prospective electrophysiological and clinical study performed in patients with clinically "silent" spondylotic cervical cord compression. Thirty patients with MR signs of spondylotic cervical cord compression but without clinical signs of myelopathy were evaluated clinically and using SEPs and MEPs during a 2-year period. The results of the study showed that SEPs and MEPs documented subclinical involvement of cervical cord in 50% of patients with clinically "silent" spondylotic cervical cord compression. During the 2-year period clinical signs of cervical myelopathy were observed in one-third of patients with entry EP abnormality in comparison with no patients with normal EP tests. Combined SEPs and MEPs proved to be a valuable tool in the assessment of the functional relevance of subclinical spondylotic cervical cord compression. Normal EP findings predict a favourable 2-year clinical outcome.

Case-Control Studies↗

PubMed2006

Effect of compressive strain on cell viability in statically loaded articular cartilage.

Physiological loading of articulating joints is necessary for normal cartilage function. However, conditions of excessive overloading or trauma can cause cartilage injury resulting in matrix damage and cell death. The objective of this study was to evaluate chondrocyte viability within mechanically compressed articular cartilage removed from immature and mature bovine knees. Twenty-three mature and 68 immature cartilage specimens were subjected to static uniaxial confined-creep compressions of 0-70% and the extent of cell death was measured using fluorescent microscopic imaging. In both age groups, cell death was always initiated at the articular surface and increased linearly in depth with increasing strain magnitude. However, most of the cell death was localized within the superficial zone (SZ) of the cartilage matrix with the depth never greater than approximately 500 microm or 25% of the thickness of the test specimen. The immature cartilage was found to have a significantly greater (> 2 times) amount (depth) of cell death compared to the mature cartilage, especially at the higher strains. This finding was attributed to the lower compressive modulus of the immature cartilage in the SZ compared to that of the mature cartilage, resulting in a greater local matrix strain and concomitant cell surface membrane strain in this zone when the matrix was compressed. These results provide further insight into the capacity of articular cartilage in different age groups to resist the severity of traumatic injury from compressive loads.

Aging↗

PubMed2006

The effect of finite compressive strain on chondrocyte viability in statically loaded bovine articular cartilage.

Recent studies have reported that certain regimes of compressive loading of articular cartilage result in increased cell death in the superficial tangential zone (STZ). The objectives of this study were (1) to test the prevalent hypothesis that preferential cell death in the STZ results from excessive compressive strain in that zone, relative to the middle and deep zones, by determining whether cell death correlates with the magnitude of compressive strain and (2) to test the corollary hypothesis that the viability response of cells is uniform through the thickness of the articular layer when exposed to the same loading environment. Live cartilage explants were statically compressed by approximately 65% of their original thickness, either normal to the articular surface (axial loading) or parallel to it (transverse loading). Cell viability after 12 h was compared to the local strain distribution measured by digital image correlation. Results showed that the strain distribution in the axially loaded samples was highest in the STZ (77%) and lowest in the deep zone (55%), whereas the strain was uniformly distributed in the transversely loaded samples (64%). In contrast, axially and transversely loaded samples exhibited very similar profiles of cell death through the depth, with a preferential distribution in the STZ. Unloaded control samples showed negligible cell death. Thus, under prolonged static loading, depth-dependent variations in chondrocyte death did not correlate with the local depth-dependent compressive strain, and the prevalent hypothesis must be rejected. An alternative hypothesis, suggested by these results, is that superficial zone chondrocytes are more vulnerable to prolonged static loading than chondrocytes in the middle and deep zones.

Animals↗

PubMed2002

Irreversible compression of medical images.

The volume of data from medical imaging is growing at exponential rates, matching or exceeding the decline in the costs of digital data storage. While methods to reversibly compress image data do exist, current methods only achieve modest reductions in storage requirements. Irreversible compression can achieve substantially higher compression ratios without perceptible image degradation. These techniques are routinely applied in teleradiology, and often in Picture Archiving and Communications Systems. The practicing radiologist needs to understand how these compression techniques work and the nature of the degradation that occurs in order to optimize their medical practice. This paper describes the technology and artifacts commonly used in irreversible compression of medical images.

Artifacts↗

PubMed2004

A perceptual evaluation of JPEG 2000 image compression for digital mammography: contrast-detail characteristics.

In this investigation the effect of JPEG 2000 compression on the contrast-detail (CD) characteristics of digital mammography images was studied using an alternative forced choice (AFC) technique. Images of a contrast-detail phantom, acquired using a clinical full-field digital mammography system, were compressed using a commercially available software product (JPEG 2000). Data compression was achieved at ratios of 1:1, 10:1, 20:1, and 30:1 and the images were reviewed by seven observers on a high-resolution display. Psychophysical detection characteristics were first computed by fitting perception data using a maximum-likelihood technique from which CD curves were derived at 50%, 62.5%, and 75% threshold levels. Statistical analysis indicated no significant difference in the perception of mean disk thickness up to 20:1 compression except for disk diameter of 1 mm. All other compression combinations exhibited significant degradation in CD characteristics.

Algorithms↗

PubMed2003

Influence of spinal cord compression on the C3-C4 propriospinal neurons in cats.

The C3-C4 propriospinal neurons (PNs) transmit motor signals to forelimb motoneurons. Stem axons of the PNs bifurcate in the same segments and send ascending axons to the lateral reticular nucleus (LRN) as well as descending axons to the cervical motor nucleus. After laminectomy of decerebrated cats, ascending axons were stimulated by tungsten electrodes placed in the LRN. The N1 descending incoming volleys via axon reflexes with a latency of approximately 1.5 ms (N1 potential) were recorded in the forelimb motoneuron pools at C8 segment. We compressed the spinal cord at C3 or C6 segment by 6 x 5 mm plastic material and analyzed amplitudes of the N1 potentials at C8 motoneuron pools. After spinal compression step by step until 3000 microm from the surface for 30 min at the C3 segment, the amplitude of N1 potentials decreased to approximately 39.7% of the control. On the other hand, the amplitude of N1 potentials changed little after the same compression of the C6 segment. The N1 potentials during compression of the C3 segment did not recover to the initial amplitude of 63.5% after decompression. It is concluded that activities of axons at C3 segment are more sensitive than those at C6 to compression of the spinal cord. We discuss the properties of the bifurcation of the stem axons and the central spinal cord injury.

Animals↗

PubMed1980

Acute nerve compression during limb ischaemia--an experimental study.

In 6 baboons the deep peroneal nerve was compressed for 1 hr by a weighted cord laid over the leg just above the ankle. The procedure was carried out on both sides in a single experiment. On one side the whole leg was rendered ischaemic by a cuff round the thigh which was maintained for 3 or 4 hr before and during the period of nerve compression at the ankle. As judged by the severity of the conduction block at the ankle 24 hr later, and its subsequent recovery, the compressed nerves which were also made ischaemic fared no worse than those subjected to compression alone. Histological studies showed evidence of selective damage to large myelinated fibres during the compression; this damage was not increased on the ischaemic side. There is thus no evidence that ischaemia increased the susceptibility of nerve fibres to mechanical damage in these experiments.

Acute Disease↗

PubMed1985

Effects of acute nerve compression on conduction of impulse trains of increasing frequency.

The acute effect of localized nerve compression has been detected electrophysiologically in isolated rat tail nerve by utilizing a special stimulus pattern, a STIF (Stimulus Train of Increasing Frequency), which shows the highest frequency that the most sensitive axons in a compound potential can transmit through the compressed region. The same method also detected recovery after release of compression. Overlap of waveforms at high frequencies of stimulation required special techniques to permit unequivocal measurements. The best endpoint at which to detect the acute nerve compression in these experiments was found to be that frequency at which only a few fibers were blocked. The method was also effective when part of the nerve was completely blocked by the compression, and was more sensitive than measure of change in latency of a single response.

Acute Disease↗

PubMed2004

Direct measurements of the compressive properties of single proteoglycan aggregates.

Proteoglycan aggregate is a major component of the extracellular matrix in articular cartilage and is considered to be responsible for the resistance to compression of this tissue. The reduced stiffness of articular cartilage due to the loss of proteoglycan aggregate has been reported in osteoarthritis. In order to understand the mechanical properties of extracellular matrix in articular cartilage at molecular level, the compressive properties of 36 single molecules of proteoglycan aggregate were directly measured using a laser tweezers/interferometer system. The proteoglycan aggregates showed resistance when compressed to approximately 30% of their contour length. The stiffness of proteoglycan aggregates increased non-linearly from 2.6+/-3.8 pN/microm (compressed to 30-35% of their contour length) to 115.5+/-30.9 pN/microm (compressed to 2.5-5% of their contour length).

Compressive Strength↗

PubMed2006

Recursive versus sequential multiple error measures reduction: a curve simplification approach to ECG data compression.

Previous time domain compression methods have been tackled by sequential one point at a time sub-optimal selection strategies running in approximately O(N) or all points at a time optimal strategies running in approximately O(N3) temporal complexities. Yet basically, the selected dominant points (DPs) are locally only significant in these methods, which may lead to inaccurate reconstruction or even loss of clinical data. Alternatively, the recursive one point at a time selection strategy, through different variants of the Douglas-Peucker line simplification algorithm, computes globally significant DPs for an approximately O(N.log2(N)) temporal complexity. We illustrate that the recursive strategy performs numerically almost two times better than the sequential one. The piecewise linear approximation of the input ECG is formally expressed as a curve simplification problem, through reduction of the Hausdorff error measure. We also illustrate that reduction of two error measures performs better than reduction of one error measure. An additional compression option is proposed in the case of the recursive strategy through simplification of the sorted distances associated to the selected set of points. The outcome is a compression algorithm that yields compression ratios ranging from 8:1 to 22:1 for a perceptually good reconstruction quality and near linear execution time. The tests have been conducted on the MIT-BIH public ECG database. Results show that the proposed recursive algorithm is an excellent compromise on compression ratio - computational time - reconstruction quality.

Algorithms↗

PubMed2006

Adaptive threshold-based block classification in medical image compression for teleradiology.

Telemedicine, among other things, involves storage and transmission of medical images, popularly known as teleradiology. Due to constraints on bandwidth and storage capacity, a medical image may be needed to be compressed before transmission/storage. Among various compression techniques, transform-based techniques that convert an image in spatial domain into the data in spectral domain are very effective. Discrete cosine transform (DCT) is possibly the most popular transform used in compression of images in standards like Joint Photographic Experts Group (JPEG). In DCT-based compression the image is split into smaller blocks for computational simplicity. The blocks are classified on the basis of information content to maximize compression ratio without sacrificing diagnostic information. The present paper presents a technique along with computational algorithm for classification of blocks on the basis of an adaptive threshold value of variance. The adaptive approach makes the classification technique applicable across the board to all medical images. Its efficacy is demonstrated by applying it to CT, X-ray and ultrasound images and by comparing the results against the JPEG in terms of various objective quality indices.

Algorithms↗

PubMed2004

Chronic nerve compression induces local demyelination and remyelination in a rat model of carpal tunnel syndrome.

In a previous study, we demonstrated that chronic compression of rat sciatic nerve, a model of compressive neuropathies, triggered dramatic Schwann cell proliferation and concurrent apoptosis. Importantly, this Schwann cell response occurred before there are signs of overt axonal pathology, raising the question of whether there are alterations in axonal myelination in the areas of the nerve in which Schwann cell apoptosis and proliferation occur. Here, we use nerve teasing techniques and unbiased stereology to assess myelination in nerves after 1 and 8 months of compression. Evaluations of myelin thickness and axonal diameter (AD) using design-based, unbiased stereology revealed alterations in myelin structure that indicate remyelination, specifically a dramatic decrease in the average internodal length (IL) and an increase in the proportion of axons with thin myelin sheaths. The mean IL was reduced after 1 month of chronic nerve injury with no further decrease in IL at 8 months. There was limited change in average axonal diameter at both 1 and 8 months. Measures of myelin thickness revealed not only a greater than 6-fold increase in the number of axons with very thin (<5 microm thickness) myelin sheaths, but also a proportional decrease in the number of axons with the thick myelin sheaths characteristic of normal nerve. These results confirm that an early consequence of chronic nerve compression (CNC) is local demyelination and remyelination, which may be the primary cause of alterations in nerve function during the early period post-compression.

Animals↗

PubMed2005

Non-uniform strain distribution within rat cartilaginous growth plate under uniaxial compression.

Growth plates are highly inhomogeneous in morphology and composition. Mechanical loading can modulate longitudinal bone growth, though the mechanisms underlying this mechanobiology are poorly understood. The proximal tibial growth plates of six rats were tested in vitro under uniaxial compression to 5% strain, and confocal microscopy was used to track and capture images of fluorescently labeled cell nuclei with increasing applied strains. The local strain patterns through the growth plate thickness were quantified using texture correlation analysis. The technique of texture correlation analysis was first validated by comparing theoretical simulated strain maps generated from numerically distorted images. The texture correlation algorithm was sensitive to the grid size superimposed on the original image, but remained insensitive to parameters related to the size of the final image mask, which was searched by the correlation algorithm for each grid point of the original image. Within the growth plate, experimental strain distributions were non-uniform in all six specimens. Growth plates were mostly under compression strains. The strain distributions differed among the histomorphological zones of the growth plate, which was most obvious in specimens with regular growth plate shape: higher compressive strains (4-8 times higher than the applied 5% strain) were located mainly in regions overlapping the reserve and hypertrophic zones with lower compressive strains in the proliferative zone. This study documents the non-uniform mechanical behavior of growth plate across its three histological zones when exposed to compression. Further investigation is required to establish the significance of non-uniform strain fields during growth in vivo.

Algorithms↗

PubMed2004

Wavelet-based ultra-high compression of multidimensional NMR data sets.

The application of a lossy data compression algorithm based on wavelet transform to 2D NMR spectra is presented. We show that this algorithm affords rapid and extreme compression ratios (e.g., 800:1), providing high quality reconstructed 2D spectra. The algorithm was evaluated to ensure that qualitative and quantitative information are retained in the compressed NMR spectra. Whilst the maximum compression ratio that can be achieved depends on the number of signals and on the difference between the most and the least intense peaks (dynamic range), a compression ratio of 80:1 is affordable even for the challenging case of homonuclear 2D experiments of large biomolecules.

Algorithms↗

PubMed2006

Classification of symptomatic osteoporotic compression fractures of the thoracic and lumbar spine.

The pathophysiology of osteoporotic compression fractures is different from those occurring secondary to traumatic spinal injury, and currently, there is no classification suitable for symptomatic osteoporotic compression fractures treated by percutaneous vertebroplasty. We propose a new classification based on the radiological appearance in the subacute or chronic stage of the clinical presentation of these fractures. They are classified by the authors based on observations and measurements from preoperative and postoperative dynamic lateral radiographs. Compression fractures are divided into two types. Type I is a compression fracture involving the anterior column only. Type II is a fracture involving both the anterior and middle column. Each type is divided into two groups: fractures with union and those with non-union. Type II compression fractures have a higher incidence of non-union than type I (p<0.05). In both type I and II non-union groups, fractures achieve greater increase in vertebral body height after vertebroplasty than both type I and type II union group fractures (p<0.05). In both non-union groups, fractures achieved a greater reduction of kyphotic angle post-vertebroplasty than type I and II union group fractures (p<0.05). Further clinical follow-up of these patients will confirm and extend this classification.

Body Weight↗

PubMed2005

The role of viscoelasticity of collagen fibers in articular cartilage: axial tension versus compression.

The role of viscoelasticity of collagen fibers in bovine articular cartilage was examined in compression and tension using stress relaxation measurements in the axial direction (normal to the articular surface). Experimentally, for a given axial strain, both peak and equilibrium loads were higher in tension than in compression, whereas stress relaxation was stronger in compression, as indicated by the higher peak-to-equilibrium ratios. A viscoelastic fibril-reinforced model including fluid flow was used for analysis of the experimental data. The collagen fibrillar matrix was assumed to be viscoelastic with a strain-dependent tensile modulus, and the nonfibrillar matrix was modeled as linearly elastic. For axial tension, collagen viscoelasticity was found to account for most of the stress relaxation, while the effects of fluid pressurization on the tensile stress were negligible. In contrast, for axial compression, the dominant mechanism for stress relaxation arose from fluid pressurization, while the associated relaxation in collagen fibers mainly resulted in an increase in radial strain. The effective Poisson's ratio, defined as the ratio of the radial and axial strains, was generally smaller in compression than in tension, and deviated from the true Poisson's ratio in tensile tests because of the frictional contacts between the specimen and the loading platens. Furthermore, lower collagen elasticity in the axial direction was observed than in the radial direction. This study illustrates the essential role of collagen viscoelasticity and interstitial fluid pressurization in the mechanical response of articular cartilage.

Animals↗