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Synaptopodin is the founding member of a family of actin-associated proline-rich proteins. It is present in a subset of telencephalic dendritic spines, where it is tightly associated with the dendritic spine apparatus, a putative calcium store. Synaptopodin-deficient mice lack the spine apparatus and show deficits in long-term potentiation and spatial memory. Thus, synaptopodin appears to play a role in synaptic plasticity. In the present thesis, three major questions were addressed: (1) What is the distribution of synaptopodin and the spine apparatus in identified hippocampal neurons? (2) Is the distribution of synaptopodin affected by denervation? (3) Is synaptopodin involved in the regulation of denervation-induced spine loss? The major findings of this thesis are: (1) Immunohistochemistry in the hippocampus of wildtype and EGFP-transgenic mice revealed significant layer-specific differences in the prevalence of synaptopodin at the level of individual neurons. (2) Light and electron microscopic analysis also revealed the presence of synaptopodin in axon initial segments of cortical and hippocampal principal neurons. There, it was found to be an essential component of the cisternal organelle, a putative axonal homologue of the dendritic spine apparatus. (3) Immunohistochemistry in the rat fascia dentata before and following entorhinal deafferentation revealed changes in synaptopodin expression in denervated and non-denervated layers of the hippocampus, suggesting that the distribution of synaptopodin in hippocampal neurons is regulated by presynaptic signals. (4) The dynamics of denervation-induced spine plasticity were studied in vitro using confocal live imaging of organotypic entorhino-hippocampal slice cultures. Whereas spines were remarkably stable under control conditions, spine loss and spine formation were seen following denervation. No significant differences were observed between cultures from wildtype and synaptopodin-deficient mice, suggesting that synaptopodin is not involved in lesion-induced spine plasticity. (5) Finally, a set of transgenic mice expressing fluorescently tagged synaptopodin were generated to facilitate future experiments on the dynamics and function of synaptopodin. In summary, this thesis presents novel findings on (1) the subcellular distribution of synaptopodin in spines and the axon initial segment, (2) the molecular composition of the cisternal organelle, and (3) the dynamics of spines and the spine apparatus organelle following deafferentation in vivo and in vitro.
Objectives: To investigate the diagnostic accuracy of color-coded contrast-enhanced dual-energy CT virtual noncalcium (VNCa) reconstructions for the assessment of lumbar disk herniation compared to unenhanced VNCa imaging.
Methods: A total of 91 patients were retrospectively evaluated (65 years ± 16; 43 women) who had undergone third-generation dual-source dual-energy CT and 3.0-T MRI within an examination interval up to 3 weeks between November 2019 and December 2020. Eight weeks after assessing unenhanced color-coded VNCa reconstructions for the presence and degree of lumbar disk herniation, corresponding contrast-enhanced portal venous phase color-coded VNCa reconstructions were independently analyzed by the same five radiologists. MRI series were additionally analyzed by one highly experienced musculoskeletal radiologist and served as reference standard.
Results: MRI depicted 210 herniated lumbar disks in 91 patients. VNCa reconstructions derived from contrast-enhanced CT scans showed similar high overall sensitivity (93% vs 95%), specificity (94% vs 95%), and accuracy (94% vs 95%) for the assessment of lumbar disk herniation compared to unenhanced VNCa images (all p > .05). Interrater agreement in VNCa imaging was excellent for both, unenhanced and contrast-enhanced CT (κ = 0.84 vs κ = 0.86; p > .05). Moreover, ratings for diagnostic confidence, image quality, and noise differed not significantly between unenhanced and contrast-enhanced VNCa series (all p > .05).
Conclusions: Color-coded VNCa reconstructions derived from contrast-enhanced dual-energy CT yield similar diagnostic accuracy for the depiction of lumbar disk herniation compared to unenhanced VNCa imaging and therefore may improve opportunistic retrospective lumbar disk herniation assessment, particularly in case of staging CT examinations.
Key Points
• Color-coded dual-source dual-energy CT virtual noncalcium (VNCa) reconstructions derived from portal venous phase yield similar high diagnostic accuracy for the assessment of lumbar disk herniation compared to unenhanced VNCa CT series (94% vs 95%) with MRI serving as a standard of reference.
• Diagnostic confidence, image quality, and noise levels differ not significantly between unenhanced and contrast-enhanced portal venous phase VNCa dual-energy CT series.
• Dual-source dual-energy CT might have the potential to improve opportunistic retrospective lumbar disk herniation assessment in CT examinations performed for other indications through reconstruction of VNCa images.
Objectives: To determine the diagnostic accuracy of dual-energy CT (DECT) virtual noncalcium (VNCa) reconstructions for assessing thoracic disk herniation compared to standard grayscale CT. Methods: In this retrospective study, 87 patients (1131 intervertebral disks; mean age, 66 years; 47 women) who underwent third-generation dual-source DECT and 3.0-T MRI within 3 weeks between November 2016 and April 2020 were included. Five blinded radiologists analyzed standard DECT and color-coded VNCa images after a time interval of 8 weeks for the presence and degree of thoracic disk herniation and spinal nerve root impingement. Consensus reading of independently evaluated MRI series served as the reference standard, assessed by two separate experienced readers. Additionally, image ratings were carried out by using 5-point Likert scales. Results: MRI revealed a total of 133 herniated thoracic disks. Color-coded VNCa images yielded higher overall sensitivity (624/665 [94%; 95% CI, 0.89–0.96] vs 485/665 [73%; 95% CI, 0.67–0.80]), specificity (4775/4990 [96%; 95% CI, 0.90–0.98] vs 4066/4990 [82%; 95% CI, 0.79–0.84]), and accuracy (5399/5655 [96%; 95% CI, 0.93–0.98] vs 4551/5655 [81%; 95% CI, 0.74–0.86]) for the assessment of thoracic disk herniation compared to standard CT (all p < .001). Interrater agreement was excellent for VNCa and fair for standard CT (ϰ = 0.82 vs 0.37; p < .001). In addition, VNCa imaging achieved higher scores regarding diagnostic confidence, image quality, and noise compared to standard CT (all p < .001). Conclusions: Color-coded VNCa imaging yielded substantially higher diagnostic accuracy and confidence for assessing thoracic disk herniation compared to standard CT.