Abstract
Using positron emission computerized tomography (PCT), a high uptake of IV injected 13N-ammonia was observed in the muscles of the right forearm and leg of a patient with a rightsided static tremor. In some muscles the concentration of 13NH3 was 8.5 times higher than in the symmetrical normal limb. Confrontation of the clinical, neurological, and electromyographic findings with the results of the PCT proved that the muscles with the high uptake corresponded to the muscles responsible for the tremulous movements. There is strong evidence that the high uptake of 13NH3 was related to the increased blood flow produced by the continuous rhythmic exercise of the muscles involved in the tremor. To our knowledge a similar observation has not been described before. It is suggested that the combined use of suitable positron emitters and PCT might provide a valuable tool for the noninvasive study of perfusion of individual skeletal muscles.
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Christenson J, Larsson I, Svensson S-E, Westling H (1977) Distribution of intravenously injected 201thallium in the legs during walking. Eur J Nucl Med 2:85–88
Gronemeyer SA, Brownell GL, Elmaleh DR, Athanasoulis CA (1980) Transverse section imaging of soft tissue tumors and peripheral vascular disease. Semin Nucl Med 10:392–399
Harper PV, Lathrop KA, Krizek H, Lembares N, Stark V, Hoffer PB (1972) Clinical feasibility of myocardial imaging with 13NH3. JNM 13:278–280
Hunter WW, Monahan WG (1971) 13N-ammonia: A new physiologic radiotracer for molecular medicine. JNM 12:368
Lockwood AH, McDonald JM, Reiman RE, Gelbard AS, Laughlin JS, Duffy TE, Plum F (1979) The dynamics of ammonia metabolism in man: Effects of liver disease and hyperammonemia. J Clin Invest 63:449–460
Monahan WG, Tilbury RS, Laughlin JS (1972) Uptake of 13N-labeled ammonia. JNM 13:274–277
Nilsson B, Ingvar DH (1967) Intramuscular pressure and contractile strength related to muscle blood flow in man. Scand J Clin Lab Invest, Suppl 99:31–38
Pavoni P, Moen T, Rhodes BA, Wagner HN Jr (1971) Changes in 133Xe clearances resulting from electrically induced muscle contractions. I. Study in dog. J Nucl Med Allied Sci 15:16–18
Phelps ME, Hoffman EJ, Huang S-C, Kuhl DE (1978) ECAT: A new computerized tomographic imaging system for positron emitting radiopharmaceuticals. JNM 19:635–647
Sapirstein LA (1958) Regional blood flow by fractional distribution of indicators. Am J Physiol 193:161–168
Schelberg HR, Phelps ME, Hoffman EJ, Huang S-C (1980) Regional myocardial perfusion assessed by nitrogen-13-labeled ammonia and positron emission computerized axial tomography. In: Horst W, Wagner HN Jr, Buchanan J (ed) Frontiers in Nuclear Medicine. Springer Verlag, Berlin Heidelberg New York, pp 20–34
Seder JS, Botvinick EH, rahimtoola SH, Goldstone J, Price DC (1981) Detecting and localizing peripheral arterial disease: assessment of 201 Tl scintigraphy. AJR 137:373–380
Siegel ME, Giargiana FA, White RI, Friedman BH, Wagner HN Jr (1975) Peripheral vascular perfusion scanning. AJR 125:628–633
Siegel ME, Siemsen JK (1978) A new noninvasive approach to peripheral vascular disease: Thallium-201 leg scans. AJR 131:827–830
Slegers G, Vandecasesteele C, Sambre J (1980) Cyclotron production of 13N-labelled ammonia for medical use. J Radioanal Chem 59:585–587
Spencer RP (1980) Analysis of tissue extraction of radiopotassium analogues and 13N-ammonia. Int J Nucl Med Biol 7:327–332
Steinbach JJ, pendergast D, Cerretelli P, Blau M, Wicke R (1980) Measurement of limb blood flow at exercise—A new technique (Abstr.) JMM 21:P35
Walsh WF, Harper PV, Resnekow L, Fill H (1976) Noninvasive evaluation of regional myocardial perfusion in 112 pateints using a mobile scintillation camera and intravenous nitrogen-13-labeled ammonia. Circulation 54:266–275
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Schelstraete, K., Simons, M., Deman, J. et al. Visualization of muscles involved in unilateral tremor using 13N-ammonia and positron emission tomography. Eur J Nucl Med 7, 422–425 (1982). https://doi.org/10.1007/BF00256824
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DOI: https://doi.org/10.1007/BF00256824