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|00000590| 00 00 00 00 a0 b4 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 30 37 30 30 7d |que_ID{Y|RB00700}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 52 61 64 69 6f 67 72 |..$Title|{Radiogr|
|000005c0| 61 70 68 69 63 20 46 65 | 61 74 75 72 65 73 20 6f |aphic Fe|atures o|
|000005d0| 66 20 42 6f 6e 65 20 4c | 65 6e 67 74 68 65 6e 69 |f Bone L|engtheni|
|000005e0| 6e 67 20 50 72 6f 63 65 | 64 75 72 65 73 7d 0d 0a |ng Proce|dures}..|
|000005f0| 24 41 75 74 68 6f 72 7b | 0d 0a 56 61 64 65 2c 20 |$Author{|..Vade, |
|00000600| 41 0d 0a 45 69 73 73 65 | 6e 73 74 61 74 2c 20 52 |A..Eisse|nstat, R|
|00000610| 7d 0d 0a 24 41 66 66 69 | 6c 69 61 74 69 6f 6e 7b |}..$Affi|liation{|
|00000620| 55 6e 69 76 20 6f 66 20 | 49 6c 6c 69 6e 6f 69 73 |Univ of |Illinois|
|00000630| 2c 20 43 68 69 63 61 67 | 6f 7d 0d 0a 24 4a 6f 75 |, Chicag|o}..$Jou|
|00000640| 72 6e 61 6c 7b 52 61 64 | 69 6f 6c 6f 67 79 7d 0d |rnal{Rad|iology}.|
|00000650| 0a 24 56 6f 6c 75 6d 65 | 7b 31 37 34 7d 0d 0a 24 |.$Volume|{174}..$|
|00000660| 50 61 67 65 7b 35 33 31 | 2d 35 33 37 7d 0d 0a 24 |Page{531|-537}..$|
|00000670| 44 61 74 65 7b 31 39 39 | 30 7d 0d 0a 24 59 42 56 |Date{199|0}..$YBV|
|00000680| 6f 6c 7b 31 39 39 31 20 | 59 65 61 72 20 42 6f 6f |ol{1991 |Year Boo|
|00000690| 6b 20 6f 66 20 44 69 61 | 67 6e 6f 73 74 69 63 20 |k of Dia|gnostic |
|000006a0| 52 61 64 69 6f 6c 6f 67 | 79 7d 0d 0a 24 43 68 61 |Radiolog|y}..$Cha|
|000006b0| 70 74 65 72 7b 36 2d 33 | 32 7d 0d 0a 24 59 42 45 |pter{6-3|2}..$YBE|
|000006c0| 64 69 74 6f 72 7b 44 72 | 73 2e 20 48 65 6e 64 65 |ditor{Dr|s. Hende|
|000006d0| 65 2c 20 4b 65 61 74 73 | 2c 20 4b 69 72 6b 70 61 |e, Keats|, Kirkpa|
|000006e0| 74 72 69 63 6b 2c 20 4d | 69 6c 6c 65 72 2c 20 4f |trick, M|iller, O|
|000006f0| 73 62 6f 72 6e 2c 20 52 | 65 65 64 2c 20 61 6e 64 |sborn, R|eed, and|
|00000700| 20 54 68 6f 6d 70 73 6f | 6e 7d 0d 0a 24 54 61 62 | Thompso|n}..$Tab|
|00000710| 6c 65 7b 7d 0d 0a 24 43 | 6f 6d 6d 65 6e 74 61 74 |le{}..$C|ommentat|
|00000720| 6f 72 7b 4a 2e 41 2e 20 | 4b 69 72 6b 70 61 74 72 |or{J.A. |Kirkpatr|
|00000730| 69 63 6b 2c 20 4a 72 2e | 2c 20 4d 2e 44 2e 7d 0d |ick, Jr.|, M.D.}.|
|00000740| 0a 0d 0a 43 6f 70 79 72 | 69 67 68 74 20 28 43 29 |...Copyr|ight (C)|
|00000750| 20 59 65 61 72 20 42 6f | 6f 6b 20 4d 65 64 69 63 | Year Bo|ok Medic|
|00000760| 61 6c 20 50 75 62 6c 69 | 73 68 65 72 73 2c 20 49 |al Publi|shers, I|
|00000770| 6e 63 2e 20 31 39 39 31 | 0d 0a 0d 0a 31 39 39 31 |nc. 1991|....1991|
|00000780| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 44 69 | Year Bo|ok of Di|
|00000790| 61 67 6e 6f 73 74 69 63 | 20 52 61 64 69 6f 6c 6f |agnostic| Radiolo|
|000007a0| 67 79 0d 0a 0d 0a 43 68 | 61 70 74 65 72 20 36 20 |gy....Ch|apter 6 |
|000007b0| 2d 2d 20 50 65 64 69 61 | 74 72 69 63 20 52 61 64 |-- Pedia|tric Rad|
|000007c0| 69 6f 6c 6f 67 79 0d 0a | 0d 0a 4d 75 73 63 75 6c |iology..|..Muscul|
|000007d0| 6f 73 6b 65 6c 65 74 61 | 6c 0d 0a 0d 0a 2d 2d 2d |oskeleta|l....---|
|000007e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000810| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000820| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 52 61 64 |--------|---..Rad|
|00000830| 69 6f 67 72 61 70 68 69 | 63 20 46 65 61 74 75 72 |iographi|c Featur|
|00000840| 65 73 20 6f 66 20 42 6f | 6e 65 20 4c 65 6e 67 74 |es of Bo|ne Lengt|
|00000850| 68 65 6e 69 6e 67 20 50 | 72 6f 63 65 64 75 72 65 |hening P|rocedure|
|00000860| 73 0d 0a 0d 0a 56 61 64 | 65 20 41 3b 20 45 69 73 |s....Vad|e A; Eis|
|00000870| 73 65 6e 73 74 61 74 20 | 52 0d 0a 28 55 6e 69 76 |senstat |R..(Univ|
|00000880| 20 6f 66 20 49 6c 6c 69 | 6e 6f 69 73 2c 20 43 68 | of Illi|nois, Ch|
|00000890| 69 63 61 67 6f 29 0d 0a | 52 61 64 69 6f 6c 6f 67 |icago)..|Radiolog|
|000008a0| 79 20 31 37 34 3a 35 33 | 31 2d 35 33 37 2c 20 31 |y 174:53|1-537, 1|
|000008b0| 39 39 30 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |990..---|--------|
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|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000900| 2d 2d 2d 0d 0a 0d 0a 41 | 62 73 74 72 61 63 74 0d |---....A|bstract.|
|00000910| 0a 0d 0a 20 20 20 20 20 | 54 68 65 20 73 75 63 63 |...     |The succ|
|00000920| 65 73 73 66 75 6c 20 74 | 72 65 61 74 6d 65 6e 74 |essful t|reatment|
|00000930| 20 6f 66 20 6c 65 67 20 | 6c 65 6e 67 74 68 20 64 | of leg |length d|
|00000940| 69 73 63 72 65 70 61 6e | 63 79 20 64 65 70 65 6e |iscrepan|cy depen|
|00000950| 64 73 20 6f 6e 20 61 63 | 63 75 72 61 74 65 0d 0a |ds on ac|curate..|
|00000960| 61 73 73 65 73 73 6d 65 | 6e 74 20 6f 66 20 74 68 |assessme|nt of th|
|00000970| 65 20 70 61 74 74 65 72 | 6e 20 6f 66 20 66 65 6d |e patter|n of fem|
|00000980| 75 72 20 61 6e 64 20 74 | 69 62 69 61 20 67 72 6f |ur and t|ibia gro|
|00000990| 77 74 68 20 61 6e 64 20 | 61 20 74 68 6f 72 6f 75 |wth and |a thorou|
|000009a0| 67 68 0d 0a 75 6e 64 65 | 72 73 74 61 6e 64 69 6e |gh..unde|rstandin|
|000009b0| 67 20 6f 66 20 74 68 65 | 20 74 72 65 61 74 6d 65 |g of the| treatme|
|000009c0| 6e 74 20 6f 70 74 69 6f | 6e 73 20 61 76 61 69 6c |nt optio|ns avail|
|000009d0| 61 62 6c 65 2e 20 20 54 | 6f 20 63 6f 6d 70 61 72 |able.  T|o compar|
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|00000a30| 65 20 77 68 65 74 68 65 | 72 0d 0a 72 61 64 69 6f |e whethe|r..radio|
|00000a40| 6c 6f 67 69 63 20 6d 6f | 6e 69 74 6f 72 69 6e 67 |logic mo|nitoring|
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|00000a60| 6e 69 6e 67 20 61 6e 64 | 20 68 65 61 6c 69 6e 67 |ning and| healing|
|00000a70| 20 69 73 20 69 6d 70 6f | 72 74 61 6e 74 20 66 6f | is impo|rtant fo|
|00000a80| 72 20 74 68 65 0d 0a 65 | 61 72 6c 79 20 64 65 74 |r the..e|arly det|
|00000a90| 65 63 74 69 6f 6e 20 61 | 6e 64 20 74 72 65 61 74 |ection a|nd treat|
|00000aa0| 6d 65 6e 74 20 6f 66 20 | 63 6f 6d 70 6c 69 63 61 |ment of |complica|
|00000ab0| 74 69 6f 6e 73 2c 20 34 | 33 20 73 75 72 67 65 72 |tions, 4|3 surger|
|00000ac0| 69 65 73 20 77 65 72 65 | 20 73 74 75 64 69 65 64 |ies were| studied|
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|00000af0| 74 79 20 72 65 73 75 6c | 74 65 64 20 66 72 6f 6d |ty resul|ted from|
|00000b00| 20 6d 69 73 61 6c 69 67 | 6e 6d 65 6e 74 20 6f 66 | misalig|nment of|
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|00000b80| 74 20 74 68 65 20 6c 65 | 6e 67 74 68 65 6e 65 64 |t the le|ngthened|
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|00000c40| 61 70 68 69 63 20 64 65 | 74 65 63 74 69 6f 6e 20 |aphic de|tection |
|00000c50| 6f 66 20 61 6e 6f 6d 61 | 6c 69 65 73 2e 0d 0a 20 |of anoma|lies... |
|00000c60| 20 20 20 20 42 65 63 61 | 75 73 65 20 6d 6f 73 74 |    Beca|use most|
|00000c70| 20 62 6f 6e 65 20 61 6e | 64 20 6d 65 74 61 6c 6c | bone an|d metall|
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|00000d70| 6e 67 20 68 61 73 20 6f | 63 63 75 72 72 65 64 20 |ng has o|ccurred |
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|00000da0| 68 79 20 6f 66 20 74 68 | 65 20 6c 65 67 20 73 68 |hy of th|e leg sh|
|00000db0| 6f 75 6c 64 20 62 65 20 | 64 6f 6e 65 20 69 6e 20 |ould be |done in |
|00000dc0| 62 6f 74 68 20 61 6e 74 | 65 72 6f 70 6f 73 74 65 |both ant|eroposte|
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|00001050| 24 44 61 74 65 7b 31 39 | 38 39 7d 0d 0a 24 59 42 |$Date{19|89}..$YB|
|00001060| 56 6f 6c 7b 31 39 39 31 | 20 59 65 61 72 20 42 6f |Vol{1991| Year Bo|
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|00001170| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 69 61 67 |ear Book| of Diag|
|00001180| 6e 6f 73 74 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |nostic R|adiology|
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|000011a0| 20 50 65 64 69 61 74 72 | 69 63 20 52 61 64 69 6f | Pediatr|ic Radio|
|000011b0| 6c 6f 67 79 0d 0a 0d 0a | 4d 75 73 63 75 6c 6f 73 |logy....|Musculos|
|000011c0| 6b 65 6c 65 74 61 6c 0d | 0a 0d 0a 2d 2d 2d 2d 2d |keletal.|...-----|
|000011d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 54 75 6d 6f 72 |--------|-..Tumor|
|00001220| 2d 49 6e 64 75 63 65 64 | 20 4f 73 74 65 6f 6d 61 |-Induced| Osteoma|
|00001230| 6c 61 63 69 61 20 61 6e | 64 20 52 69 63 6b 65 74 |lacia an|d Ricket|
|00001240| 73 0d 0a 0d 0a 4e 75 6f | 76 6f 20 4d 41 3b 20 44 |s....Nuo|vo MA; D|
|00001250| 6f 72 66 6d 61 6e 20 48 | 44 3b 20 53 75 6e 20 43 |orfman H|D; Sun C|
|00001260| 2d 43 4a 3b 20 43 68 61 | 6c 65 77 20 53 41 0d 0a |-CJ; Cha|lew SA..|
|00001270| 28 4d 6f 6e 74 65 66 69 | 6f 72 65 20 4d 65 64 20 |(Montefi|ore Med |
|00001280| 43 74 72 2f 41 6c 62 65 | 72 74 20 45 69 6e 73 74 |Ctr/Albe|rt Einst|
|00001290| 65 69 6e 20 43 6f 6c 6c | 65 67 65 20 6f 66 20 4d |ein Coll|ege of M|
|000012a0| 65 64 69 63 69 6e 65 2c | 20 42 72 6f 6e 78 3b 20 |edicine,| Bronx; |
|000012b0| 55 6e 69 76 20 6f 66 0d | 0a 4d 61 72 79 6c 61 6e |Univ of.|.Marylan|
|000012c0| 64 20 48 6f 73 70 2c 20 | 42 61 6c 74 69 6d 6f 72 |d Hosp, |Baltimor|
|000012d0| 65 29 20 41 6d 20 4a 20 | 53 75 72 67 20 50 61 74 |e) Am J |Surg Pat|
|000012e0| 68 6f 6c 20 31 33 3a 35 | 38 38 2d 35 39 39 2c 20 |hol 13:5|88-599, |
|000012f0| 31 39 38 39 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1989..--|--------|
|00001300| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001310| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001320| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001330| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001340| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00001350| 0d 0a 0d 0a 20 20 20 20 | 20 54 75 6d 6f 72 2d 69 |....    | Tumor-i|
|00001360| 6e 64 75 63 65 64 20 6f | 73 74 65 6f 6d 61 6c 61 |nduced o|steomala|
|00001370| 63 69 61 20 69 73 20 61 | 20 63 6c 69 6e 69 63 6f |cia is a| clinico|
|00001380| 70 61 74 68 6f 6c 6f 67 | 69 63 20 65 6e 74 69 74 |patholog|ic entit|
|00001390| 79 20 69 6e 20 77 68 69 | 63 68 20 76 69 74 61 6d |y in whi|ch vitam|
|000013a0| 69 6e 0d 0a 44 2d 72 65 | 73 69 73 74 61 6e 74 20 |in..D-re|sistant |
|000013b0| 6f 73 74 65 6f 6d 61 6c | 61 63 69 61 20 6f 72 20 |osteomal|acia or |
|000013c0| 72 69 63 6b 65 74 73 20 | 6f 63 63 75 72 73 20 69 |rickets |occurs i|
|000013d0| 6e 20 61 73 73 6f 63 69 | 61 74 69 6f 6e 20 77 69 |n associ|ation wi|
|000013e0| 74 68 20 61 20 74 75 6d | 6f 72 2e 0d 0a 53 65 76 |th a tum|or...Sev|
|000013f0| 65 6e 74 79 2d 74 77 6f | 20 28 36 39 20 69 6e 20 |enty-two| (69 in |
|00001400| 74 68 65 20 6c 69 74 65 | 72 61 74 75 72 65 20 61 |the lite|rature a|
|00001410| 6e 64 20 33 20 63 75 72 | 72 65 6e 74 29 20 63 61 |nd 3 cur|rent) ca|
|00001420| 73 65 73 20 68 61 76 65 | 20 62 65 65 6e 20 72 65 |ses have| been re|
|00001430| 70 6f 72 74 65 64 2e 0d | 0a 54 68 65 20 73 79 6e |ported..|.The syn|
|00001440| 64 72 6f 6d 65 20 61 66 | 66 65 63 74 73 20 6d 65 |drome af|fects me|
|00001450| 6e 20 61 6e 64 20 77 6f | 6d 65 6e 20 65 71 75 61 |n and wo|men equa|
|00001460| 6c 6c 79 2c 20 61 6e 64 | 20 6d 6f 73 74 20 70 61 |lly, and| most pa|
|00001470| 74 69 65 6e 74 73 20 61 | 72 65 20 6f 6c 64 65 72 |tients a|re older|
|00001480| 20 74 68 61 6e 0d 0a 61 | 67 65 20 33 30 20 79 65 | than..a|ge 30 ye|
|00001490| 61 72 73 2e 0d 0a 20 20 | 20 20 20 46 6f 72 74 79 |ars...  |   Forty|
|000014a0| 20 62 6f 6e 65 20 74 75 | 6d 6f 72 73 20 61 6e 64 | bone tu|mors and|
|000014b0| 20 33 31 20 73 6f 66 74 | 20 74 69 73 73 75 65 20 | 31 soft| tissue |
|000014c0| 74 75 6d 6f 72 73 20 77 | 65 72 65 20 72 65 73 70 |tumors w|ere resp|
|000014d0| 6f 6e 73 69 62 6c 65 20 | 66 6f 72 20 74 68 65 0d |onsible |for the.|
|000014e0| 0a 73 79 6e 64 72 6f 6d | 65 20 28 74 61 62 6c 65 |.syndrom|e (table|
|000014f0| 29 2e 20 20 54 77 6f 20 | 74 68 69 72 64 73 20 6f |).  Two |thirds o|
|00001500| 66 20 74 68 65 20 74 75 | 6d 6f 72 73 20 6f 63 63 |f the tu|mors occ|
|00001510| 75 72 72 65 64 20 69 6e | 20 74 68 65 20 65 78 74 |urred in| the ext|
|00001520| 72 65 6d 69 74 69 65 73 | 20 28 46 69 67 0d 0a 36 |remities| (Fig..6|
|00001530| 2d 32 31 29 2c 20 61 6e | 64 20 6d 6f 73 74 20 70 |-21), an|d most p|
|00001540| 61 74 69 65 6e 74 73 20 | 68 61 64 20 70 72 6f 67 |atients |had prog|
|00001550| 72 65 73 73 69 76 65 20 | 6c 6f 77 65 72 20 6c 65 |ressive |lower le|
|00001560| 67 20 61 6e 64 20 62 61 | 63 6b 20 70 61 69 6e 2e |g and ba|ck pain.|
|00001570| 20 20 54 79 70 69 63 61 | 6c 0d 0a 63 68 65 6d 69 |  Typica|l..chemi|
|00001580| 63 61 6c 20 66 69 6e 64 | 69 6e 67 73 20 69 6e 63 |cal find|ings inc|
|00001590| 6c 75 64 65 64 20 6c 6f | 77 20 73 65 72 75 6d 20 |luded lo|w serum |
|000015a0| 6c 65 76 65 6c 73 20 6f | 66 20 70 68 6f 73 70 68 |levels o|f phosph|
|000015b0| 6f 72 75 73 2c 20 6e 6f | 72 6d 61 6c 20 73 65 72 |orus, no|rmal ser|
|000015c0| 75 6d 20 6c 65 76 65 6c | 73 0d 0a 6f 66 20 63 61 |um level|s..of ca|
|000015d0| 6c 63 69 75 6d 2c 20 61 | 6e 64 20 69 6e 63 72 65 |lcium, a|nd incre|
|000015e0| 61 73 65 64 20 6c 65 76 | 65 6c 73 20 6f 66 20 61 |ased lev|els of a|
|000015f0| 6c 6b 61 6c 69 6e 65 20 | 70 68 6f 73 70 68 61 74 |lkaline |phosphat|
|00001600| 61 73 65 2e 20 20 53 65 | 72 75 6d 20 6c 65 76 65 |ase.  Se|rum leve|
|00001610| 6c 73 20 6f 66 0d 0a 31 | 2c 32 35 2d 64 69 68 79 |ls of..1|,25-dihy|
|00001620| 64 72 6f 78 79 76 69 74 | 61 6d 69 6e 20 44 20 77 |droxyvit|amin D w|
|00001630| 65 72 65 20 75 6e 64 65 | 74 65 63 74 61 62 6c 65 |ere unde|tectable|
|00001640| 20 6f 72 20 6c 6f 77 2e | 0d 0a 20 20 20 20 20 41 | or low.|..     A|
|00001650| 6d 6f 6e 67 20 74 68 65 | 20 6f 74 68 65 72 20 63 |mong the| other c|
|00001660| 6f 6d 6d 6f 6e 20 64 69 | 61 67 6e 6f 73 65 73 20 |ommon di|agnoses |
|00001670| 77 65 72 65 20 6e 6f 6e | 6f 73 73 69 66 79 69 6e |were non|ossifyin|
|00001680| 67 20 66 69 62 72 6f 6d | 61 73 20 61 6e 64 0d 0a |g fibrom|as and..|
|00001690| 6d 65 73 65 6e 63 68 79 | 6d 61 6c 20 61 6e 64 20 |mesenchy|mal and |
|000016a0| 67 69 61 6e 74 20 63 65 | 6c 6c 20 74 75 6d 6f 72 |giant ce|ll tumor|
|000016b0| 20 76 61 72 69 61 6e 74 | 73 2e 20 20 54 68 65 20 | variant|s.  The |
|000016c0| 74 75 6d 6f 72 73 20 63 | 6f 6d 6d 6f 6e 6c 79 20 |tumors c|ommonly |
|000016d0| 68 61 64 20 70 72 6f 6d | 69 6e 65 6e 74 0d 0a 76 |had prom|inent..v|
|000016e0| 61 73 63 75 6c 61 72 69 | 74 79 20 61 6e 64 20 67 |asculari|ty and g|
|000016f0| 69 61 6e 74 20 61 6e 64 | 20 70 72 69 6d 69 74 69 |iant and| primiti|
|00001700| 76 65 20 73 74 72 6f 6d | 61 6c 20 63 65 6c 6c 73 |ve strom|al cells|
|00001710| 2e 20 20 4f 6e 6c 79 20 | 31 30 20 74 75 6d 6f 72 |.  Only |10 tumor|
|00001720| 73 20 77 65 72 65 0d 0a | 6d 61 6c 69 67 6e 61 6e |s were..|malignan|
|00001730| 74 20 68 69 73 74 6f 6c | 6f 67 69 63 61 6c 6c 79 |t histol|ogically|
|00001740| 2e 20 20 43 6f 6d 70 6c | 65 74 65 20 72 65 6d 6f |.  Compl|ete remo|
|00001750| 76 61 6c 20 6f 66 20 74 | 68 65 20 74 75 6d 6f 72 |val of t|he tumor|
|00001760| 20 67 65 6e 65 72 61 6c | 6c 79 20 72 65 73 75 6c | general|ly resul|
|00001770| 74 73 20 69 6e 0d 0a 64 | 72 61 6d 61 74 69 63 20 |ts in..d|ramatic |
|00001780| 72 65 76 65 72 73 61 6c | 20 6f 66 20 73 69 67 6e |reversal| of sign|
|00001790| 73 20 61 6e 64 20 73 79 | 6d 70 74 6f 6d 73 20 6f |s and sy|mptoms o|
|000017a0| 66 20 6f 73 74 65 6f 6d | 61 6c 61 63 69 61 2e 0d |f osteom|alacia..|
|000017b0| 0a 20 20 20 20 20 41 6c | 74 68 6f 75 67 68 20 75 |.     Al|though u|
|000017c0| 6c 74 72 61 73 74 72 75 | 63 74 75 72 61 6c 20 73 |ltrastru|ctural s|
|000017d0| 74 75 64 69 65 73 20 64 | 69 64 20 6e 6f 74 20 73 |tudies d|id not s|
|000017e0| 68 6f 77 20 61 6e 79 20 | 73 65 63 72 65 74 6f 72 |how any |secretor|
|000017f0| 79 20 67 72 61 6e 75 6c | 65 73 0d 0a 73 75 67 67 |y granul|es..sugg|
|00001800| 65 73 74 69 6e 67 20 68 | 6f 72 6d 6f 6e 65 2d 73 |esting h|ormone-s|
|00001810| 65 63 72 65 74 69 6e 67 | 20 74 75 6d 6f 72 20 69 |ecreting| tumor i|
|00001820| 6e 20 74 68 65 20 63 61 | 73 65 73 20 72 65 70 6f |n the ca|ses repo|
|00001830| 72 74 65 64 20 69 6e 20 | 74 68 65 20 77 6f 72 6c |rted in |the worl|
|00001840| 64 0d 0a 6c 69 74 65 72 | 61 74 75 72 65 2c 20 69 |d..liter|ature, i|
|00001850| 74 20 69 73 20 63 6c 65 | 61 72 20 74 68 61 74 20 |t is cle|ar that |
|00001860| 74 68 65 20 74 75 6d 6f | 72 73 20 77 65 72 65 20 |the tumo|rs were |
|00001870| 72 65 73 70 6f 6e 73 69 | 62 6c 65 20 66 6f 72 20 |responsi|ble for |
|00001880| 74 68 65 20 6f 73 74 65 | 6f 6d 61 6c 61 63 69 61 |the oste|omalacia|
|00001890| 2e 0d 0a 0d 0a 50 6f 73 | 74 2d 43 6f 6d 6d 65 6e |.....Pos|t-Commen|
|000018a0| 74 0d 0a 0d 0a 20 20 20 | 20 20 54 68 69 73 20 69 |t....   |  This i|
|000018b0| 73 20 61 20 63 6f 6d 70 | 72 65 68 65 6e 73 69 76 |s a comp|rehensiv|
|000018c0| 65 20 64 69 73 63 75 73 | 73 69 6f 6e 20 6f 66 20 |e discus|sion of |
|000018d0| 74 68 65 20 72 65 6c 61 | 74 69 6f 6e 73 68 69 70 |the rela|tionship|
|000018e0| 20 6f 66 20 74 75 6d 6f | 72 73 20 74 6f 0d 0a 6f | of tumo|rs to..o|
|000018f0| 73 74 65 6f 6d 61 6c 61 | 63 69 61 20 61 6e 64 20 |steomala|cia and |
|00001900| 72 69 63 6b 65 74 73 2e | 20 20 54 68 65 20 74 61 |rickets.|  The ta|
|00001910| 62 6c 65 20 6c 69 73 74 | 73 20 61 20 73 75 72 70 |ble list|s a surp|
|00001920| 72 69 73 69 6e 67 20 61 | 72 72 61 79 20 6f 66 20 |rising a|rray of |
|00001930| 74 75 6d 6f 72 73 20 74 | 68 61 74 0d 0a 68 61 76 |tumors t|hat..hav|
|00001940| 65 20 62 65 65 6e 20 61 | 73 73 6f 63 69 61 74 65 |e been a|ssociate|
|00001950| 64 20 77 69 74 68 20 72 | 69 63 6b 65 74 73 2f 6f |d with r|ickets/o|
|00001960| 73 74 65 6f 6d 61 6c 61 | 63 69 61 2e 20 20 54 68 |steomala|cia.  Th|
|00001970| 69 73 20 69 73 20 61 20 | 70 61 70 65 72 20 74 6f |is is a |paper to|
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|00001990| 76 65 64 20 62 65 63 61 | 75 73 65 20 6f 66 20 69 |ved beca|use of i|
|000019a0| 74 73 20 63 6f 6d 70 6c | 65 74 65 6e 65 73 73 2e |ts compl|eteness.|
|000019b0| 20 20 44 72 2e 20 50 2e | 20 52 69 74 73 63 68 6c |  Dr. P.| Ritschl|
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|000019d0| 75 65 73 2c 20 69 6e 0d | 0a 61 20 72 65 6c 61 74 |ues, in.|.a relat|
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|000019f0| 65 20 4d 52 49 20 61 70 | 70 65 61 72 61 6e 63 65 |e MRI ap|pearance|
|00001a00| 73 20 6f 66 20 66 69 62 | 72 6f 75 73 20 6d 65 74 |s of fib|rous met|
|00001a10| 61 70 68 79 73 65 61 6c | 20 64 65 66 65 63 74 73 |aphyseal| defects|
|00001a20| 3b 20 74 68 65 73 65 0d | 0a 6c 65 73 69 6f 6e 73 |; these.|.lesions|
|00001a30| 20 69 6e 20 74 68 65 20 | 61 72 74 69 63 6c 65 20 | in the |article |
|00001a40| 62 79 20 44 72 2e 20 4e | 75 6f 76 6f 20 61 6e 64 |by Dr. N|uovo and|
|00001a50| 20 63 6f 6c 6c 65 61 67 | 75 65 73 20 77 65 72 65 | colleag|ues were|
|00001a60| 20 72 65 73 70 6f 6e 73 | 69 62 6c 65 20 66 6f 72 | respons|ible for|
|00001a70| 20 38 0d 0a 69 6e 73 74 | 61 6e 63 65 73 20 6f 66 | 8..inst|ances of|
|00001a80| 20 72 69 63 6b 65 74 73 | 2e 2d 2d 4a 2e 41 2e 20 | rickets|.--J.A. |
|00001a90| 4b 69 72 6b 70 61 74 72 | 69 63 6b 2c 20 4a 72 2e |Kirkpatr|ick, Jr.|
|00001aa0| 2c 20 4d 2e 44 2e 0d 0a | 24 55 6e 69 71 75 65 5f |, M.D...|$Unique_|
|00001ab0| 49 44 7b 59 52 42 30 30 | 37 30 32 7d 0d 0a 24 54 |ID{YRB00|702}..$T|
|00001ac0| 69 74 6c 65 7b 53 6f 66 | 74 2d 54 69 73 73 75 65 |itle{Sof|t-Tissue|
|00001ad0| 20 54 75 6d 6f 72 73 20 | 6f 66 20 74 68 65 20 48 | Tumors |of the H|
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|00001af0| 20 43 68 69 6c 64 72 65 | 6e 7d 0d 0a 24 41 75 74 | Childre|n}..$Aut|
|00001b00| 68 6f 72 7b 0d 0a 41 7a | 6f 75 7a 2c 20 45 4d 0d |hor{..Az|ouz, EM.|
|00001b10| 0a 4b 6f 7a 6c 6f 77 73 | 6b 69 2c 20 4b 0d 0a 4d |.Kozlows|ki, K..M|
|00001b20| 61 73 65 6c 2c 20 4a 7d | 0d 0a 24 41 66 66 69 6c |asel, J}|..$Affil|
|00001b30| 69 61 74 69 6f 6e 7b 4d | 6f 6e 74 72 65 61 6c 20 |iation{M|ontreal |
|00001b40| 43 68 69 6c 64 72 65 6e | 27 73 20 48 6f 73 70 3b |Children|'s Hosp;|
|00001b50| 20 52 6f 79 61 6c 20 41 | 6c 65 78 61 6e 64 72 61 | Royal A|lexandra|
|00001b60| 20 48 6f 73 70 20 66 6f | 72 20 43 68 69 6c 64 72 | Hosp fo|r Childr|
|00001b70| 65 6e 2c 0d 0a 43 61 6d | 70 65 72 64 6f 77 6e 2c |en,..Cam|perdown,|
|00001b80| 20 41 75 73 74 72 61 6c | 69 61 3b 20 52 6f 79 61 | Austral|ia; Roya|
|00001b90| 6c 20 43 68 69 6c 64 72 | 65 6e 27 73 20 48 6f 73 |l Childr|en's Hos|
|00001ba0| 70 2c 20 42 72 69 73 62 | 61 6e 65 2c 20 41 75 73 |p, Brisb|ane, Aus|
|00001bb0| 74 72 61 6c 69 61 7d 0d | 0a 24 4a 6f 75 72 6e 61 |tralia}.|.$Journa|
|00001bc0| 6c 7b 4a 20 43 61 6e 20 | 41 73 73 6f 63 20 52 61 |l{J Can |Assoc Ra|
|00001bd0| 64 69 6f 6c 7d 0d 0a 24 | 56 6f 6c 75 6d 65 7b 34 |diol}..$|Volume{4|
|00001be0| 30 7d 0d 0a 24 50 61 67 | 65 7b 32 35 31 2d 32 35 |0}..$Pag|e{251-25|
|00001bf0| 35 7d 0d 0a 24 44 61 74 | 65 7b 31 39 38 39 7d 0d |5}..$Dat|e{1989}.|
|00001c00| 0a 24 59 42 56 6f 6c 7b | 31 39 39 31 20 59 65 61 |.$YBVol{|1991 Yea|
|00001c10| 72 20 42 6f 6f 6b 20 6f | 66 20 44 69 61 67 6e 6f |r Book o|f Diagno|
|00001c20| 73 74 69 63 20 52 61 64 | 69 6f 6c 6f 67 79 7d 0d |stic Rad|iology}.|
|00001c30| 0a 24 43 68 61 70 74 65 | 72 7b 36 2d 33 34 7d 0d |.$Chapte|r{6-34}.|
|00001c40| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00001c50| 48 65 6e 64 65 65 2c 20 | 4b 65 61 74 73 2c 20 4b |Hendee, |Keats, K|
|00001c60| 69 72 6b 70 61 74 72 69 | 63 6b 2c 20 4d 69 6c 6c |irkpatri|ck, Mill|
|00001c70| 65 72 2c 20 4f 73 62 6f | 72 6e 2c 20 52 65 65 64 |er, Osbo|rn, Reed|
|00001c80| 2c 20 61 6e 64 20 54 68 | 6f 6d 70 73 6f 6e 7d 0d |, and Th|ompson}.|
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|00001cb0| 61 74 6f 72 7b 4a 2e 41 | 2e 20 4b 69 72 6b 70 61 |ator{J.A|. Kirkpa|
|00001cc0| 74 72 69 63 6b 2c 20 4a | 72 2e 2c 20 4d 2e 44 2e |trick, J|r., M.D.|
|00001cd0| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|00001ce0| 43 29 20 59 65 61 72 20 | 42 6f 6f 6b 20 4d 65 64 |C) Year |Book Med|
|00001cf0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00001d00| 20 49 6e 63 2e 20 31 39 | 39 31 0d 0a 0d 0a 31 39 | Inc. 19|91....19|
|00001d10| 39 31 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |91 Year |Book of |
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|00001d40| 36 20 2d 2d 20 50 65 64 | 69 61 74 72 69 63 20 52 |6 -- Ped|iatric R|
|00001d50| 61 64 69 6f 6c 6f 67 79 | 0d 0a 0d 0a 4d 75 73 63 |adiology|....Musc|
|00001d60| 75 6c 6f 73 6b 65 6c 65 | 74 61 6c 0d 0a 0d 0a 2d |uloskele|tal....-|
|00001d70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001d80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001da0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001db0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 53 |--------|-----..S|
|00001dc0| 6f 66 74 2d 54 69 73 73 | 75 65 20 54 75 6d 6f 72 |oft-Tiss|ue Tumor|
|00001dd0| 73 20 6f 66 20 74 68 65 | 20 48 61 6e 64 20 61 6e |s of the| Hand an|
|00001de0| 64 20 57 72 69 73 74 20 | 6f 66 20 43 68 69 6c 64 |d Wrist |of Child|
|00001df0| 72 65 6e 0d 0a 0d 0a 41 | 7a 6f 75 7a 20 45 4d 3b |ren....A|zouz EM;|
|00001e00| 20 4b 6f 7a 6c 6f 77 73 | 6b 69 20 4b 3b 20 4d 61 | Kozlows|ki K; Ma|
|00001e10| 73 65 6c 20 4a 0d 0a 28 | 4d 6f 6e 74 72 65 61 6c |sel J..(|Montreal|
|00001e20| 20 43 68 69 6c 64 72 65 | 6e 27 73 20 48 6f 73 70 | Childre|n's Hosp|
|00001e30| 3b 20 52 6f 79 61 6c 20 | 41 6c 65 78 61 6e 64 72 |; Royal |Alexandr|
|00001e40| 61 20 48 6f 73 70 20 66 | 6f 72 20 43 68 69 6c 64 |a Hosp f|or Child|
|00001e50| 72 65 6e 2c 20 43 61 6d | 70 65 72 64 6f 77 6e 2c |ren, Cam|perdown,|
|00001e60| 0d 0a 41 75 73 74 72 61 | 6c 69 61 3b 20 52 6f 79 |..Austra|lia; Roy|
|00001e70| 61 6c 20 43 68 69 6c 64 | 72 65 6e 27 73 20 48 6f |al Child|ren's Ho|
|00001e80| 73 70 2c 20 42 72 69 73 | 62 61 6e 65 2c 20 41 75 |sp, Bris|bane, Au|
|00001e90| 73 74 72 61 6c 69 61 29 | 20 4a 20 43 61 6e 20 41 |stralia)| J Can A|
|00001ea0| 73 73 6f 63 20 52 61 64 | 69 6f 6c 0d 0a 34 30 3a |ssoc Rad|iol..40:|
|00001eb0| 32 35 31 2d 32 35 35 2c | 20 31 39 38 39 0d 0a 2d |251-255,| 1989..-|
|00001ec0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 0d |--------|-----...|
|00001f10| 0a 41 62 73 74 72 61 63 | 74 0d 0a 0d 0a 20 20 20 |.Abstrac|t....   |
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|00001f30| 68 61 6e 64 20 6f 72 20 | 77 72 69 73 74 20 61 72 |hand or |wrist ar|
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|00001f60| 73 75 65 20 6c 65 73 69 | 6f 6e 73 0d 0a 61 72 65 |sue lesi|ons..are|
|00001f70| 20 65 76 65 6e 20 72 61 | 72 65 72 20 69 66 20 62 | even ra|rer if b|
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|00002600| 31 39 34 7d 0d 0a 24 44 | 61 74 65 7b 31 39 38 39 |194}..$D|ate{1989|
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|00002630| 6e 6f 73 74 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |nostic R|adiology|
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|00002650| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00002660| 2e 20 48 65 6e 64 65 65 | 2c 20 4b 65 61 74 73 2c |. Hendee|, Keats,|
|00002670| 20 4b 69 72 6b 70 61 74 | 72 69 63 6b 2c 20 4d 69 | Kirkpat|rick, Mi|
|00002680| 6c 6c 65 72 2c 20 4f 73 | 62 6f 72 6e 2c 20 52 65 |ller, Os|born, Re|
|00002690| 65 64 2c 20 61 6e 64 20 | 54 68 6f 6d 70 73 6f 6e |ed, and |Thompson|
|000026a0| 7d 0d 0a 24 54 61 62 6c | 65 7b 7d 0d 0a 24 43 6f |}..$Tabl|e{}..$Co|
|000026b0| 6d 6d 65 6e 74 61 74 6f | 72 7b 4a 2e 41 2e 20 4b |mmentato|r{J.A. K|
|000026c0| 69 72 6b 70 61 74 72 69 | 63 6b 2c 20 4a 72 2e 2c |irkpatri|ck, Jr.,|
|000026d0| 20 4d 2e 44 2e 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 | M.D.}..|..Copyri|
|000026e0| 67 68 74 20 28 43 29 20 | 59 65 61 72 20 42 6f 6f |ght (C) |Year Boo|
|000026f0| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00002700| 68 65 72 73 2c 20 49 6e | 63 2e 20 31 39 39 31 0d |hers, In|c. 1991.|
|00002710| 0a 0d 0a 31 39 39 31 20 | 59 65 61 72 20 42 6f 6f |...1991 |Year Boo|
|00002720| 6b 20 6f 66 20 44 69 61 | 67 6e 6f 73 74 69 63 20 |k of Dia|gnostic |
|00002730| 52 61 64 69 6f 6c 6f 67 | 79 0d 0a 0d 0a 43 68 61 |Radiolog|y....Cha|
|00002740| 70 74 65 72 20 36 20 2d | 2d 20 50 65 64 69 61 74 |pter 6 -|- Pediat|
|00002750| 72 69 63 20 52 61 64 69 | 6f 6c 6f 67 79 0d 0a 0d |ric Radi|ology...|
|00002760| 0a 4d 75 73 63 75 6c 6f | 73 6b 65 6c 65 74 61 6c |.Musculo|skeletal|
|00002770| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|00002780| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002790| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000027a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000027b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000027c0| 2d 2d 0d 0a 44 75 6d 62 | 2d 42 65 6c 6c 20 47 61 |--..Dumb|-Bell Ga|
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|00002800| 72 65 73 73 69 76 65 20 | 49 64 69 6f 70 61 74 68 |ressive |Idiopath|
|00002810| 69 63 0d 0a 53 63 6f 6c | 69 6f 73 69 73 3a 20 20 |ic..Scol|iosis:  |
|00002820| 43 61 73 65 20 52 65 70 | 6f 72 74 0d 0a 0d 0a 42 |Case Rep|ort....B|
|00002830| 61 75 65 72 20 42 4c 3b | 20 42 61 75 65 72 20 48 |auer BL;| Bauer H|
|00002840| 3b 20 47 72 69 73 73 20 | 50 3b 20 4c 75 74 63 6b |; Griss |P; Lutck|
|00002850| 65 20 41 3b 20 4d 61 72 | 6f 73 6b 65 20 44 3b 20 |e A; Mar|oske D; |
|00002860| 4d 65 6e 6e 65 6c 20 48 | 44 3b 20 55 6e 73 69 63 |Mennel H|D; Unsic|
|00002870| 6b 65 72 20 4b 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |ker K..(|Univ of |
|00002880| 4d 61 72 62 75 72 67 2c | 20 47 65 72 6d 61 6e 79 |Marburg,| Germany|
|00002890| 29 0d 0a 41 72 63 68 20 | 4f 72 74 68 6f 70 20 54 |)..Arch |Orthop T|
|000028a0| 72 61 75 6d 61 20 53 75 | 72 67 20 31 30 38 3a 31 |rauma Su|rg 108:1|
|000028b0| 38 39 2d 31 39 34 2c 20 | 31 39 38 39 0d 0a 2d 2d |89-194, |1989..--|
|000028c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000028d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000028e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000028f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00002910| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|....    |
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|000033e0| 2c 20 4d 69 6c 6c 65 72 | 2c 20 4f 73 62 6f 72 6e |, Miller|, Osborn|
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|000034c0| 79 0d 0a 0d 0a 54 68 6f | 72 61 78 0d 0a 0d 0a 2d |y....Tho|rax....-|
|000034d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000034e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000034f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003500| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003510| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 50 |--------|-----..P|
|00003520| 75 6c 6d 6f 6e 61 72 79 | 20 56 61 73 63 75 6c 61 |ulmonary| Vascula|
|00003530| 72 69 74 79 20 69 6e 20 | 50 65 64 69 61 74 72 69 |rity in |Pediatri|
|00003540| 63 20 48 65 61 72 74 20 | 44 69 73 65 61 73 65 0d |c Heart |Disease.|
|00003550| 0a 0d 0a 53 77 69 73 63 | 68 75 6b 20 4c 45 3b 20 |...Swisc|huk LE; |
|00003560| 53 74 61 6e 73 62 65 72 | 72 79 20 53 44 0d 0a 28 |Stansber|ry SD..(|
|00003570| 55 6e 69 76 20 6f 66 20 | 54 65 78 61 73 2c 20 47 |Univ of |Texas, G|
|00003580| 61 6c 76 65 73 74 6f 6e | 29 0d 0a 4a 20 54 68 6f |alveston|)..J Tho|
|00003590| 72 61 63 20 49 6d 61 67 | 20 34 3a 31 2d 36 2c 20 |rac Imag| 4:1-6, |
|000035a0| 31 39 38 39 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1989..--|--------|
|000035b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000035f0| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00003600| 0d 0a 0d 0a 20 20 20 20 | 20 41 6e 61 6c 79 73 69 |....    | Analysi|
|00003610| 73 20 6f 66 20 61 62 6e | 6f 72 6d 61 6c 20 70 75 |s of abn|ormal pu|
|00003620| 6c 6d 6f 6e 61 72 79 20 | 76 61 73 63 75 6c 61 72 |lmonary |vascular|
|00003630| 20 70 61 74 74 65 72 6e | 73 20 63 61 6e 20 70 72 | pattern|s can pr|
|00003640| 6f 76 69 64 65 20 73 69 | 67 6e 69 66 69 63 61 6e |ovide si|gnifican|
|00003650| 74 0d 0a 69 6e 66 6f 72 | 6d 61 74 69 6f 6e 20 61 |t..infor|mation a|
|00003660| 62 6f 75 74 20 75 6e 64 | 65 72 6c 79 69 6e 67 20 |bout und|erlying |
|00003670| 64 69 73 65 61 73 65 20 | 69 6e 20 63 68 69 6c 64 |disease |in child|
|00003680| 72 65 6e 20 61 73 20 77 | 65 6c 6c 20 61 73 20 61 |ren as w|ell as a|
|00003690| 64 75 6c 74 73 2e 0d 0a | 55 6e 64 65 72 6c 79 69 |dults...|Underlyi|
|000036a0| 6e 67 20 68 65 61 72 74 | 20 64 69 73 65 61 73 65 |ng heart| disease|
|000036b0| 20 69 73 20 70 72 65 73 | 65 6e 74 20 69 6e 20 6d | is pres|ent in m|
|000036c0| 6f 73 74 20 70 61 74 69 | 65 6e 74 73 2e 20 20 54 |ost pati|ents.  T|
|000036d0| 68 65 20 61 62 6e 6f 72 | 6d 61 6c 20 76 61 73 63 |he abnor|mal vasc|
|000036e0| 75 6c 61 72 0d 0a 70 61 | 74 74 65 72 6e 73 20 73 |ular..pa|tterns s|
|000036f0| 65 65 6e 20 69 6e 20 63 | 68 69 6c 64 72 65 6e 20 |een in c|hildren |
|00003700| 77 69 74 68 20 68 65 61 | 72 74 20 64 69 73 65 61 |with hea|rt disea|
|00003710| 73 65 20 77 65 72 65 20 | 72 65 76 69 65 77 65 64 |se were |reviewed|
|00003720| 2e 0d 0a 20 20 20 20 20 | 43 61 72 64 69 61 63 20 |...     |Cardiac |
|00003730| 70 72 6f 62 6c 65 6d 73 | 20 69 6e 20 63 68 69 6c |problems| in chil|
|00003740| 64 72 65 6e 20 61 72 65 | 20 75 73 75 61 6c 6c 79 |dren are| usually|
|00003750| 20 63 6f 6e 67 65 6e 69 | 74 61 6c 2e 20 20 41 62 | congeni|tal.  Ab|
|00003760| 6e 6f 72 6d 61 6c 20 76 | 61 73 63 75 6c 61 72 0d |normal v|ascular.|
|00003770| 0a 70 61 74 74 65 72 6e | 73 20 69 6e 20 73 75 63 |.pattern|s in suc|
|00003780| 68 20 63 68 69 6c 64 72 | 65 6e 20 69 6e 63 6c 75 |h childr|en inclu|
|00003790| 64 65 20 61 63 74 69 76 | 65 20 65 6e 67 6f 72 67 |de activ|e engorg|
|000037a0| 65 6d 65 6e 74 2c 20 70 | 61 73 73 69 76 65 20 63 |ement, p|assive c|
|000037b0| 6f 6e 67 65 73 74 69 6f | 6e 2c 0d 0a 64 69 6d 69 |ongestio|n,..dimi|
|000037c0| 6e 69 73 68 65 64 20 70 | 75 6c 6d 6f 6e 61 72 79 |nished p|ulmonary|
|000037d0| 20 62 6c 6f 6f 64 20 66 | 6c 6f 77 2c 20 63 65 70 | blood f|low, cep|
|000037e0| 68 61 6c 61 64 20 72 65 | 64 69 73 74 72 69 62 75 |halad re|distribu|
|000037f0| 74 69 6f 6e 2c 20 61 6e | 64 20 75 6e 65 71 75 61 |tion, an|d unequa|
|00003800| 6c 20 62 6c 6f 6f 64 0d | 0a 66 6c 6f 77 2e 20 20 |l blood.|.flow.  |
|00003810| 54 68 65 20 63 68 61 72 | 61 63 74 65 72 69 73 74 |The char|acterist|
|00003820| 69 63 20 72 61 64 69 6f | 67 72 61 70 68 69 63 20 |ic radio|graphic |
|00003830| 66 69 6e 64 69 6e 67 20 | 69 6e 20 61 63 74 69 76 |finding |in activ|
|00003840| 65 20 65 6e 67 6f 72 67 | 65 6d 65 6e 74 20 69 73 |e engorg|ement is|
|00003850| 0d 0a 65 6e 6c 61 72 67 | 65 6d 65 6e 74 20 6f 66 |..enlarg|ement of|
|00003860| 20 74 68 65 20 6d 61 69 | 6e 20 70 75 6c 6d 6f 6e | the mai|n pulmon|
|00003870| 61 72 79 20 61 72 74 65 | 72 79 20 61 6e 64 20 74 |ary arte|ry and t|
|00003880| 68 65 20 72 69 67 68 74 | 20 61 6e 64 20 6c 65 66 |he right| and lef|
|00003890| 74 20 70 75 6c 6d 6f 6e | 61 72 79 0d 0a 61 72 74 |t pulmon|ary..art|
|000038a0| 65 72 79 20 62 72 61 6e | 63 68 65 73 2c 20 77 69 |ery bran|ches, wi|
|000038b0| 74 68 20 6d 61 72 6b 65 | 64 6c 79 20 72 65 64 75 |th marke|dly redu|
|000038c0| 63 65 64 20 70 65 72 69 | 70 68 65 72 61 6c 20 76 |ced peri|pheral v|
|000038d0| 61 73 63 75 6c 61 72 69 | 74 79 2e 20 20 49 6e 20 |asculari|ty.  In |
|000038e0| 70 61 73 73 69 76 65 0d | 0a 63 6f 6e 67 65 73 74 |passive.|.congest|
|000038f0| 69 6f 6e 20 74 68 65 72 | 65 20 69 73 20 6c 6f 73 |ion ther|e is los|
|00003900| 73 20 6f 66 20 74 68 65 | 20 64 69 73 74 69 6e 63 |s of the| distinc|
|00003910| 74 20 62 6f 72 64 65 72 | 73 20 6f 66 20 69 6e 64 |t border|s of ind|
|00003920| 69 76 69 64 75 61 6c 20 | 70 75 6c 6d 6f 6e 61 72 |ividual |pulmonar|
|00003930| 79 20 62 6c 6f 6f 64 0d | 0a 76 65 73 73 65 6c 73 |y blood.|.vessels|
|00003940| 20 62 65 63 61 75 73 65 | 20 6f 66 20 66 6c 75 69 | because| of flui|
|00003950| 64 20 74 72 61 6e 73 75 | 64 61 74 69 6f 6e 2e 20 |d transu|dation. |
|00003960| 20 54 68 65 20 6f 76 65 | 72 61 6c 6c 20 70 69 63 | The ove|rall pic|
|00003970| 74 75 72 65 20 62 65 63 | 6f 6d 65 73 20 66 75 7a |ture bec|omes fuz|
|00003980| 7a 79 20 61 6e 64 0d 0a | 69 6e 64 69 73 74 69 6e |zy and..|indistin|
|00003990| 63 74 2e 20 20 49 6e 20 | 70 61 74 69 65 6e 74 73 |ct.  In |patients|
|000039a0| 20 77 69 74 68 20 6d 6f | 72 65 20 73 65 76 65 72 | with mo|re sever|
|000039b0| 65 20 64 69 73 65 61 73 | 65 2c 20 74 68 69 73 20 |e diseas|e, this |
|000039c0| 68 61 7a 69 6e 65 73 73 | 20 69 73 20 6d 6f 72 65 |haziness| is more|
|000039d0| 0d 0a 67 65 6e 65 72 61 | 6c 69 7a 65 64 20 61 6e |..genera|lized an|
|000039e0| 64 20 65 78 74 65 6e 64 | 73 20 66 61 72 74 68 65 |d extend|s farthe|
|000039f0| 72 20 69 6e 74 6f 20 74 | 68 65 20 70 65 72 69 70 |r into t|he perip|
|00003a00| 68 65 72 79 20 6f 66 20 | 74 68 65 20 6c 75 6e 67 |hery of |the lung|
|00003a10| 73 2e 20 20 49 6e 20 70 | 61 74 69 65 6e 74 73 0d |s.  In p|atients.|
|00003a20| 0a 77 69 74 68 20 61 64 | 76 61 6e 63 65 64 20 64 |.with ad|vanced d|
|00003a30| 69 73 65 61 73 65 2c 20 | 61 6c 76 65 6f 6c 61 72 |isease, |alveolar|
|00003a40| 20 70 75 6c 6d 6f 6e 61 | 72 79 20 65 64 65 6d 61 | pulmona|ry edema|
|00003a50| 20 69 73 20 65 76 69 64 | 65 6e 74 2e 20 20 44 69 | is evid|ent.  Di|
|00003a60| 6d 69 6e 69 73 68 65 64 | 0d 0a 70 75 6c 6d 6f 6e |minished|..pulmon|
|00003a70| 61 72 79 20 62 6c 6f 6f | 64 20 66 6c 6f 77 20 69 |ary bloo|d flow i|
|00003a80| 73 20 75 73 75 61 6c 6c | 79 20 61 73 73 6f 63 69 |s usuall|y associ|
|00003a90| 61 74 65 64 20 77 69 74 | 68 20 72 69 67 68 74 20 |ated wit|h right |
|00003aa0| 6f 75 74 66 6c 6f 77 20 | 74 72 61 63 74 0d 0a 6f |outflow |tract..o|
|00003ab0| 62 73 74 72 75 63 74 69 | 6f 6e 20 61 6e 64 20 61 |bstructi|on and a|
|00003ac0| 6e 20 61 63 63 6f 6d 6d | 6f 64 61 74 69 76 65 2c |n accomm|odative,|
|00003ad0| 20 6f 62 6c 69 67 61 74 | 6f 72 79 20 72 69 67 68 | obligat|ory righ|
|00003ae0| 74 2d 74 6f 2d 6c 65 66 | 74 20 73 68 75 6e 74 2e |t-to-lef|t shunt.|
|00003af0| 20 20 54 65 74 72 61 6c | 6f 67 79 0d 0a 6f 66 20 |  Tetral|ogy..of |
|00003b00| 46 61 6c 6c 6f 74 20 69 | 73 20 74 68 65 20 6d 6f |Fallot i|s the mo|
|00003b10| 73 74 20 63 6c 61 73 73 | 69 63 20 65 78 61 6d 70 |st class|ic examp|
|00003b20| 6c 65 20 6f 66 20 74 68 | 65 20 72 65 73 75 6c 74 |le of th|e result|
|00003b30| 69 6e 67 20 70 68 65 6e | 6f 6d 65 6e 6f 6e 2e 20 |ing phen|omenon. |
|00003b40| 20 41 20 72 69 67 68 74 | 0d 0a 61 6f 72 74 69 63 | A right|..aortic|
|00003b50| 20 61 72 63 68 20 6d 61 | 79 20 62 65 20 70 72 65 | arch ma|y be pre|
|00003b60| 73 65 6e 74 2c 20 74 68 | 65 20 70 75 6c 6d 6f 6e |sent, th|e pulmon|
|00003b70| 61 72 79 20 61 72 74 65 | 72 79 20 69 73 20 63 6f |ary arte|ry is co|
|00003b80| 6e 63 61 76 65 2c 20 61 | 6e 64 20 74 68 65 0d 0a |ncave, a|nd the..|
|00003b90| 70 65 72 69 70 68 65 72 | 61 6c 20 62 72 61 6e 63 |peripher|al branc|
|00003ba0| 68 65 73 20 61 72 65 20 | 62 61 72 65 6c 79 20 64 |hes are |barely d|
|00003bb0| 65 74 65 63 74 61 62 6c | 65 20 6f 6e 20 70 6c 61 |etectabl|e on pla|
|00003bc0| 69 6e 20 72 61 64 69 6f | 67 72 61 70 68 73 2e 20 |in radio|graphs. |
|00003bd0| 20 43 65 70 68 61 6c 61 | 64 0d 0a 72 65 64 69 73 | Cephala|d..redis|
|00003be0| 74 72 69 62 75 74 69 6f | 6e 20 6f 63 63 75 72 73 |tributio|n occurs|
|00003bf0| 20 77 69 74 68 20 6c 6f | 6e 67 2d 73 74 61 6e 64 | with lo|ng-stand|
|00003c00| 69 6e 67 20 6c 65 66 74 | 2d 73 69 64 65 64 20 6f |ing left|-sided o|
|00003c10| 62 73 74 72 75 63 74 69 | 6f 6e 20 6f 72 20 6d 79 |bstructi|on or my|
|00003c20| 6f 63 61 72 64 69 61 6c | 0d 0a 66 61 69 6c 75 72 |ocardial|..failur|
|00003c30| 65 20 69 6e 20 70 61 74 | 69 65 6e 74 73 20 77 68 |e in pat|ients wh|
|00003c40| 6f 20 61 72 65 20 75 70 | 72 69 67 68 74 20 61 6e |o are up|right an|
|00003c50| 64 20 61 6d 62 75 6c 61 | 6e 74 2c 20 6d 61 6b 69 |d ambula|nt, maki|
|00003c60| 6e 67 20 69 74 20 72 61 | 72 65 20 69 6e 20 69 6e |ng it ra|re in in|
|00003c70| 66 61 6e 74 73 0d 0a 61 | 6e 64 20 63 68 69 6c 64 |fants..a|nd child|
|00003c80| 72 65 6e 2e 20 55 6e 65 | 71 75 61 6c 20 70 75 6c |ren. Une|qual pul|
|00003c90| 6d 6f 6e 61 72 79 20 62 | 6c 6f 6f 64 20 66 6c 6f |monary b|lood flo|
|00003ca0| 77 20 6f 63 63 75 72 73 | 20 77 69 74 68 20 74 65 |w occurs| with te|
|00003cb0| 74 72 61 6c 6f 67 79 20 | 6f 66 20 46 61 6c 6c 6f |tralogy |of Fallo|
|00003cc0| 74 2c 0d 0a 70 65 72 73 | 69 73 74 65 6e 74 20 74 |t,..pers|istent t|
|00003cd0| 72 75 6e 63 75 73 20 61 | 72 74 65 72 69 6f 73 75 |runcus a|rteriosu|
|00003ce0| 73 2c 20 61 6e 64 20 70 | 75 6c 6d 6f 6e 61 72 79 |s, and p|ulmonary|
|00003cf0| 20 73 74 65 6e 6f 73 69 | 73 2e 20 20 49 6e 20 74 | stenosi|s.  In t|
|00003d00| 68 65 20 66 69 72 73 74 | 20 32 0d 0a 63 6f 6e 64 |he first| 2..cond|
|00003d10| 69 74 69 6f 6e 73 20 74 | 68 65 20 69 70 73 69 6c |itions t|he ipsil|
|00003d20| 61 74 65 72 61 6c 20 70 | 75 6c 6d 6f 6e 61 72 79 |ateral p|ulmonary|
|00003d30| 20 61 72 74 65 72 79 20 | 69 73 20 73 65 76 65 72 | artery |is sever|
|00003d40| 65 6c 79 20 68 79 70 6f | 70 6c 61 73 74 69 63 20 |ely hypo|plastic |
|00003d50| 6f 72 20 61 62 73 65 6e | 74 2e 0d 0a 20 20 20 20 |or absen|t...    |
|00003d60| 20 54 68 65 72 65 20 61 | 72 65 20 63 65 72 74 61 | There a|re certa|
|00003d70| 69 6e 20 64 69 66 66 65 | 72 65 6e 63 65 73 20 69 |in diffe|rences i|
|00003d80| 6e 20 74 68 65 20 61 70 | 70 65 61 72 61 6e 63 65 |n the ap|pearance|
|00003d90| 20 6f 66 20 74 68 65 20 | 70 75 6c 6d 6f 6e 61 72 | of the |pulmonar|
|00003da0| 79 0d 0a 76 61 73 63 75 | 6c 61 74 75 72 65 20 69 |y..vascu|lature i|
|00003db0| 6e 20 63 68 69 6c 64 72 | 65 6e 20 63 6f 6d 70 61 |n childr|en compa|
|00003dc0| 72 65 64 20 77 69 74 68 | 20 61 64 75 6c 74 73 2e |red with| adults.|
|00003dd0| 20 20 48 6f 77 65 76 65 | 72 2c 20 74 68 65 20 67 |  Howeve|r, the g|
|00003de0| 65 6e 65 72 61 6c 0d 0a | 70 61 74 68 6f 70 68 79 |eneral..|pathophy|
|00003df0| 73 69 6f 6c 6f 67 69 63 | 20 72 75 6c 65 73 20 61 |siologic| rules a|
|00003e00| 72 65 20 73 69 6d 69 6c | 61 72 2e 20 20 41 64 64 |re simil|ar.  Add|
|00003e10| 69 74 69 6f 6e 61 6c 20 | 73 74 75 64 79 20 6f 66 |itional |study of|
|00003e20| 20 74 68 65 20 63 61 72 | 64 69 61 63 20 63 68 61 | the car|diac cha|
|00003e30| 6d 62 65 72 73 2c 0d 0a | 67 72 65 61 74 20 76 65 |mbers,..|great ve|
|00003e40| 73 73 65 6c 73 2c 20 61 | 6e 64 20 6f 74 68 65 72 |ssels, a|nd other|
|00003e50| 20 66 69 6e 64 69 6e 67 | 73 20 69 6e 20 74 68 65 | finding|s in the|
|00003e60| 20 63 68 65 73 74 20 63 | 61 6e 20 6c 65 61 64 20 | chest c|an lead |
|00003e70| 74 6f 20 61 20 73 70 65 | 63 69 66 69 63 0d 0a 64 |to a spe|cific..d|
|00003e80| 69 61 67 6e 6f 73 69 73 | 2e 0d 0a 0d 0a 50 6f 73 |iagnosis|.....Pos|
|00003e90| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t....   |
|00003ea0| 20 20 49 6e 20 74 68 69 | 73 20 64 61 79 20 6f 66 |  In thi|s day of|
|00003eb0| 20 63 61 72 64 69 61 63 | 20 75 6c 74 72 61 73 6f | cardiac| ultraso|
|00003ec0| 6e 6f 67 72 61 70 68 79 | 2c 20 73 6f 70 68 69 73 |nography|, sophis|
|00003ed0| 74 69 63 61 74 65 64 20 | 63 61 72 64 69 61 63 0d |ticated |cardiac.|
|00003ee0| 0a 63 61 74 68 65 74 65 | 72 69 7a 61 74 69 6f 6e |.cathete|rization|
|00003ef0| 2c 20 73 65 6c 65 63 74 | 69 76 65 20 61 6e 67 69 |, select|ive angi|
|00003f00| 6f 63 61 72 64 69 6f 67 | 72 61 70 68 79 2c 20 61 |ocardiog|raphy, a|
|00003f10| 6e 64 2c 20 6e 6f 77 2c | 20 4d 52 49 2c 20 69 74 |nd, now,| MRI, it|
|00003f20| 20 69 73 20 65 61 73 79 | 20 74 6f 0d 0a 6f 76 65 | is easy| to..ove|
|00003f30| 72 6c 6f 6f 6b 20 74 68 | 65 20 66 69 6e 64 69 6e |rlook th|e findin|
|00003f40| 67 73 20 6f 6e 20 70 6c | 61 69 6e 20 66 69 6c 6d |gs on pl|ain film|
|00003f50| 73 20 6f 66 20 69 6e 66 | 61 6e 74 73 20 61 6e 64 |s of inf|ants and|
|00003f60| 20 63 68 69 6c 64 72 65 | 6e 20 77 69 74 68 20 68 | childre|n with h|
|00003f70| 65 61 72 74 0d 0a 64 69 | 73 65 61 73 65 2e 20 20 |eart..di|sease.  |
|00003f80| 41 6e 20 75 6e 64 65 72 | 73 74 61 6e 64 69 6e 67 |An under|standing|
|00003f90| 20 6f 66 20 74 68 65 20 | 70 61 74 74 65 72 6e 73 | of the |patterns|
|00003fa0| 20 6f 66 20 70 75 6c 6d | 6f 6e 61 72 79 20 76 61 | of pulm|onary va|
|00003fb0| 73 63 75 6c 61 72 69 74 | 79 20 69 73 0d 0a 65 73 |scularit|y is..es|
|00003fc0| 73 65 6e 74 69 61 6c 20 | 69 6e 20 61 6e 20 75 6e |sential |in an un|
|00003fd0| 64 65 72 73 74 61 6e 64 | 69 6e 67 20 6f 66 20 74 |derstand|ing of t|
|00003fe0| 68 65 20 70 61 74 68 6f | 70 68 79 73 69 6f 6c 6f |he patho|physiolo|
|00003ff0| 67 79 20 6f 66 20 68 65 | 61 72 74 20 64 69 73 65 |gy of he|art dise|
|00004000| 61 73 65 2e 20 20 4e 6f | 74 0d 0a 65 76 65 72 79 |ase.  No|t..every|
|00004010| 20 70 61 74 69 65 6e 74 | 20 77 69 74 68 20 63 6f | patient| with co|
|00004020| 6e 67 65 6e 69 74 61 6c | 20 68 65 61 72 74 20 64 |ngenital| heart d|
|00004030| 69 73 65 61 73 65 20 63 | 6f 6d 65 73 20 74 6f 20 |isease c|omes to |
|00004040| 74 68 65 20 72 61 64 69 | 6f 6c 6f 67 69 73 74 20 |the radi|ologist |
|00004050| 77 69 74 68 20 61 0d 0a | 64 69 61 67 6e 6f 73 69 |with a..|diagnosi|
|00004060| 73 3b 20 73 6f 6d 65 20 | 6f 66 20 74 68 65 73 65 |s; some |of these|
|00004070| 20 73 74 69 6c 6c 20 72 | 65 61 64 2c 20 22 52 75 | still r|ead, "Ru|
|00004080| 6c 65 20 6f 75 74 20 70 | 6e 65 75 6d 6f 6e 69 61 |le out p|neumonia|
|00004090| 2e 22 20 20 54 68 69 73 | 20 70 61 70 65 72 0d 0a |."  This| paper..|
|000040a0| 64 65 73 65 72 76 65 73 | 20 74 6f 20 62 65 20 72 |deserves| to be r|
|000040b0| 65 61 64 20 69 6e 20 69 | 74 73 20 65 6e 74 69 72 |ead in i|ts entir|
|000040c0| 65 74 79 2e 2d 2d 4a 2e | 41 2e 20 4b 69 72 6b 70 |ety.--J.|A. Kirkp|
|000040d0| 61 74 72 69 63 6b 2c 20 | 4a 72 2e 2c 20 4d 2e 44 |atrick, |Jr., M.D|
|000040e0| 2e 0d 0a 24 55 6e 69 71 | 75 65 5f 49 44 7b 59 52 |...$Uniq|ue_ID{YR|
|000040f0| 42 30 30 37 30 35 7d 0d | 0a 24 54 69 74 6c 65 7b |B00705}.|.$Title{|
|00004100| 50 72 65 6e 61 74 61 6c | 20 4d 65 61 73 75 72 65 |Prenatal| Measure|
|00004110| 6d 65 6e 74 20 6f 66 20 | 43 61 72 64 69 6f 74 68 |ment of |Cardioth|
|00004120| 6f 72 61 63 69 63 20 52 | 61 74 69 6f 20 69 6e 20 |oracic R|atio in |
|00004130| 45 76 61 6c 75 61 74 69 | 6f 6e 20 6f 66 20 48 65 |Evaluati|on of He|
|00004140| 61 72 74 0d 0a 44 69 73 | 65 61 73 65 7d 0d 0a 24 |art..Dis|ease}..$|
|00004150| 41 75 74 68 6f 72 7b 0d | 0a 50 61 6c 61 64 69 6e |Author{.|.Paladin|
|00004160| 69 2c 20 44 0d 0a 43 68 | 69 74 61 2c 20 53 4b 0d |i, D..Ch|ita, SK.|
|00004170| 0a 41 6c 6c 61 6e 2c 20 | 4c 44 7d 0d 0a 24 41 66 |.Allan, |LD}..$Af|
|00004180| 66 69 6c 69 61 74 69 6f | 6e 7b 47 75 79 27 73 20 |filiatio|n{Guy's |
|00004190| 48 6f 73 70 2c 20 4c 6f | 6e 64 6f 6e 7d 0d 0a 24 |Hosp, Lo|ndon}..$|
|000041a0| 4a 6f 75 72 6e 61 6c 7b | 41 72 63 68 20 44 69 73 |Journal{|Arch Dis|
|000041b0| 20 43 68 69 6c 64 7d 0d | 0a 24 56 6f 6c 75 6d 65 | Child}.|.$Volume|
|000041c0| 7b 36 35 7d 0d 0a 24 50 | 61 67 65 7b 32 30 2d 32 |{65}..$P|age{20-2|
|000041d0| 33 7d 0d 0a 24 44 61 74 | 65 7b 31 39 39 30 7d 0d |3}..$Dat|e{1990}.|
|000041e0| 0a 24 59 42 56 6f 6c 7b | 31 39 39 31 20 59 65 61 |.$YBVol{|1991 Yea|
|000041f0| 72 20 42 6f 6f 6b 20 6f | 66 20 44 69 61 67 6e 6f |r Book o|f Diagno|
|00004200| 73 74 69 63 20 52 61 64 | 69 6f 6c 6f 67 79 7d 0d |stic Rad|iology}.|
|00004210| 0a 24 43 68 61 70 74 65 | 72 7b 36 2d 33 37 7d 0d |.$Chapte|r{6-37}.|
|00004220| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00004230| 48 65 6e 64 65 65 2c 20 | 4b 65 61 74 73 2c 20 4b |Hendee, |Keats, K|
|00004240| 69 72 6b 70 61 74 72 69 | 63 6b 2c 20 4d 69 6c 6c |irkpatri|ck, Mill|
|00004250| 65 72 2c 20 4f 73 62 6f | 72 6e 2c 20 52 65 65 64 |er, Osbo|rn, Reed|
|00004260| 2c 20 61 6e 64 20 54 68 | 6f 6d 70 73 6f 6e 7d 0d |, and Th|ompson}.|
|00004270| 0a 24 54 61 62 6c 65 7b | 7d 0d 0a 24 43 6f 6d 6d |.$Table{|}..$Comm|
|00004280| 65 6e 74 61 74 6f 72 7b | 7d 0d 0a 0d 0a 43 6f 70 |entator{|}....Cop|
|00004290| 79 72 69 67 68 74 20 28 | 43 29 20 59 65 61 72 20 |yright (|C) Year |
|000042a0| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|000042b0| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 20 31 39 |lishers,| Inc. 19|
|000042c0| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|000042d0| 42 6f 6f 6b 20 6f 66 20 | 44 69 61 67 6e 6f 73 74 |Book of |Diagnost|
|000042e0| 69 63 20 52 61 64 69 6f | 6c 6f 67 79 0d 0a 0d 0a |ic Radio|logy....|
|000042f0| 43 68 61 70 74 65 72 20 | 36 20 2d 2d 20 50 65 64 |Chapter |6 -- Ped|
|00004300| 69 61 74 72 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |iatric R|adiology|
|00004310| 0d 0a 0d 0a 54 68 6f 72 | 61 78 0d 0a 0d 0a 2d 2d |....Thor|ax....--|
|00004320| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004330| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004340| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004350| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004360| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 50 72 |--------|----..Pr|
|00004370| 65 6e 61 74 61 6c 20 4d | 65 61 73 75 72 65 6d 65 |enatal M|easureme|
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|000043c0| 61 64 69 6e 69 20 44 3b | 20 43 68 69 74 61 20 53 |adini D;| Chita S|
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|000043e0| 79 27 73 20 48 6f 73 70 | 2c 20 4c 6f 6e 64 6f 6e |y's Hosp|, London|
|000043f0| 29 0d 0a 41 72 63 68 20 | 44 69 73 20 43 68 69 6c |)..Arch |Dis Chil|
|00004400| 64 20 36 35 3a 32 30 2d | 32 33 2c 20 31 39 39 30 |d 65:20-|23, 1990|
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|00004430| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004440| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004450| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004460| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00004470| 20 20 20 20 20 43 61 72 | 64 69 61 63 20 64 69 73 |     Car|diac dis|
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|00004950| 20 20 49 6e 20 74 68 65 | 0d 0a 73 65 63 6f 6e 64 |  In the|..second|
|00004960| 20 67 72 6f 75 70 2c 20 | 32 34 20 6f 66 20 32 39 | group, |24 of 29|
|00004970| 20 66 65 74 75 73 65 73 | 20 68 61 64 20 61 6e 20 | fetuses| had an |
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|00004990| 74 68 6f 72 61 63 69 63 | 20 72 61 74 69 6f 2e 20 |thoracic| ratio. |
|000049a0| 20 4e 6f 0d 0a 63 6c 65 | 61 72 20 70 61 74 74 65 | No..cle|ar patte|
|000049b0| 72 6e 20 6f 66 20 63 61 | 72 64 69 61 63 20 73 69 |rn of ca|rdiac si|
|000049c0| 7a 65 20 77 61 73 20 63 | 68 61 72 61 63 74 65 72 |ze was c|haracter|
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|000049e0| 6d 73 20 6f 66 20 63 6f | 6e 67 65 6e 69 74 61 6c |ms of co|ngenital|
|000049f0| 0d 0a 68 65 61 72 74 20 | 64 69 73 65 61 73 65 2e |..heart |disease.|
|00004a00| 20 20 49 6e 20 73 6f 6d | 65 20 66 65 74 75 73 65 |  In som|e fetuse|
|00004a10| 73 20 74 68 65 20 63 61 | 72 64 69 6f 74 68 6f 72 |s the ca|rdiothor|
|00004a20| 61 63 69 63 20 72 61 74 | 69 6f 20 77 61 73 20 77 |acic rat|io was w|
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|00004ac0| 54 68 65 20 63 61 72 64 | 69 6f 74 68 6f 72 61 63 |The card|iothorac|
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|00004ae0| 6e 74 69 61 6c 20 69 6e | 0d 0a 74 68 65 20 65 76 |ntial in|..the ev|
|00004af0| 61 6c 75 61 74 69 6f 6e | 20 6f 66 20 66 65 74 61 |aluation| of feta|
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|00004b10| 20 69 6e 63 72 65 61 73 | 65 64 20 76 61 6c 75 65 | increas|ed value|
|00004b20| 20 6d 61 79 20 69 6e 64 | 69 63 61 74 65 0d 0a 69 | may ind|icate..i|
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|00004b40| 6c 20 74 61 63 68 79 63 | 61 72 64 69 61 20 69 66 |l tachyc|ardia if|
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|00004b70| 70 65 72 69 6f 64 20 6f | 66 0d 0a 73 69 6e 75 73 |period o|f..sinus|
|00004b80| 20 72 68 79 74 68 6d 2e | 0d 0a 24 55 6e 69 71 75 | rhythm.|..$Uniqu|
|00004b90| 65 5f 49 44 7b 59 52 42 | 30 30 37 30 36 7d 0d 0a |e_ID{YRB|00706}..|
|00004ba0| 24 54 69 74 6c 65 7b 4d | 52 20 49 6d 61 67 69 6e |$Title{M|R Imagin|
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|00004c00| 72 7b 0d 0a 52 69 65 6e | 6d 75 6c 6c 65 72 2c 20 |r{..Rien|muller, |
|00004c10| 52 0d 0a 4c 6c 6f 72 65 | 74 2c 20 4a 4c 0d 0a 54 |R..Llore|t, JL..T|
|00004c20| 69 6c 69 6e 67 2c 20 52 | 0d 0a 47 72 6f 68 2c 20 |iling, R|..Groh, |
|00004c30| 4a 0d 0a 4d 61 6e 65 72 | 74 2c 20 57 0d 0a 4d 75 |J..Maner|t, W..Mu|
|00004c40| 6c 6c 65 72 2c 20 4b 44 | 0d 0a 53 65 69 66 65 72 |ller, KD|..Seifer|
|00004c50| 74 2c 20 4b 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |t, K}..$|Affiliat|
|00004c60| 69 6f 6e 7b 55 6e 69 76 | 20 6f 66 20 4d 75 6e 69 |ion{Univ| of Muni|
|00004c70| 63 68 3b 20 44 65 75 74 | 73 63 68 65 73 20 48 65 |ch; Deut|sches He|
|00004c80| 72 7a 7a 65 6e 74 72 75 | 6d 2c 20 4d 75 6e 69 63 |rzzentru|m, Munic|
|00004c90| 68 2c 20 47 65 72 6d 61 | 6e 79 7d 0d 0a 24 4a 6f |h, Germa|ny}..$Jo|
|00004ca0| 75 72 6e 61 6c 7b 4a 20 | 43 6f 6d 70 75 74 20 41 |urnal{J |Comput A|
|00004cb0| 73 73 69 73 74 20 54 6f | 6d 6f 67 72 7d 0d 0a 24 |ssist To|mogr}..$|
|00004cc0| 56 6f 6c 75 6d 65 7b 31 | 33 7d 0d 0a 24 50 61 67 |Volume{1|3}..$Pag|
|00004cd0| 65 7b 36 32 31 2d 36 32 | 36 7d 0d 0a 24 44 61 74 |e{621-62|6}..$Dat|
|00004ce0| 65 7b 31 39 38 39 7d 0d | 0a 24 59 42 56 6f 6c 7b |e{1989}.|.$YBVol{|
|00004cf0| 31 39 39 31 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1991 Yea|r Book o|
|00004d00| 66 20 44 69 61 67 6e 6f | 73 74 69 63 20 52 61 64 |f Diagno|stic Rad|
|00004d10| 69 6f 6c 6f 67 79 7d 0d | 0a 24 43 68 61 70 74 65 |iology}.|.$Chapte|
|00004d20| 72 7b 36 2d 33 38 7d 0d | 0a 24 59 42 45 64 69 74 |r{6-38}.|.$YBEdit|
|00004d30| 6f 72 7b 44 72 73 2e 20 | 48 65 6e 64 65 65 2c 20 |or{Drs. |Hendee, |
|00004d40| 4b 65 61 74 73 2c 20 4b | 69 72 6b 70 61 74 72 69 |Keats, K|irkpatri|
|00004d50| 63 6b 2c 20 4d 69 6c 6c | 65 72 2c 20 4f 73 62 6f |ck, Mill|er, Osbo|
|00004d60| 72 6e 2c 20 52 65 65 64 | 2c 20 61 6e 64 20 54 68 |rn, Reed|, and Th|
|00004d70| 6f 6d 70 73 6f 6e 7d 0d | 0a 24 54 61 62 6c 65 7b |ompson}.|.$Table{|
|00004d80| 54 61 62 6c 65 20 4f 6d | 69 74 74 65 64 7d 0d 0a |Table Om|itted}..|
|00004d90| 24 43 6f 6d 6d 65 6e 74 | 61 74 6f 72 7b 4a 2e 41 |$Comment|ator{J.A|
|00004da0| 2e 20 4b 69 72 6b 70 61 | 74 72 69 63 6b 2c 20 4a |. Kirkpa|trick, J|
|00004db0| 72 2e 2c 20 4d 2e 44 2e | 7d 0d 0a 0d 0a 43 6f 70 |r., M.D.|}....Cop|
|00004dc0| 79 72 69 67 68 74 20 28 | 43 29 20 59 65 61 72 20 |yright (|C) Year |
|00004dd0| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00004de0| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 20 31 39 |lishers,| Inc. 19|
|00004df0| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|00004e00| 42 6f 6f 6b 20 6f 66 20 | 44 69 61 67 6e 6f 73 74 |Book of |Diagnost|
|00004e10| 69 63 20 52 61 64 69 6f | 6c 6f 67 79 0d 0a 0d 0a |ic Radio|logy....|
|00004e20| 43 68 61 70 74 65 72 20 | 36 20 2d 2d 20 50 65 64 |Chapter |6 -- Ped|
|00004e30| 69 61 74 72 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |iatric R|adiology|
|00004e40| 0d 0a 0d 0a 54 68 6f 72 | 61 78 0d 0a 0d 0a 2d 2d |....Thor|ax....--|
|00004e50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004e90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 4d 52 |--------|----..MR|
|00004ea0| 20 49 6d 61 67 69 6e 67 | 20 6f 66 20 50 65 64 69 | Imaging| of Pedi|
|00004eb0| 61 74 72 69 63 20 43 61 | 72 64 69 61 63 20 54 75 |atric Ca|rdiac Tu|
|00004ec0| 6d 6f 72 73 20 50 72 65 | 76 69 6f 75 73 6c 79 20 |mors Pre|viously |
|00004ed0| 44 69 61 67 6e 6f 73 65 | 64 20 62 79 0d 0a 45 63 |Diagnose|d by..Ec|
|00004ee0| 68 6f 63 61 72 64 69 6f | 67 72 61 70 68 79 0d 0a |hocardio|graphy..|
|00004ef0| 0d 0a 52 69 65 6e 6d 75 | 6c 6c 65 72 20 52 3b 20 |..Rienmu|ller R; |
|00004f00| 4c 6c 6f 72 65 74 20 4a | 4c 3b 20 54 69 6c 69 6e |Lloret J|L; Tilin|
|00004f10| 67 20 52 3b 20 47 72 6f | 68 20 4a 3b 20 4d 61 6e |g R; Gro|h J; Man|
|00004f20| 65 72 74 20 57 3b 20 4d | 75 6c 6c 65 72 20 4b 44 |ert W; M|uller KD|
|00004f30| 3b 20 53 65 69 66 65 72 | 74 20 4b 0d 0a 28 55 6e |; Seifer|t K..(Un|
|00004f40| 69 76 20 6f 66 20 4d 75 | 6e 69 63 68 3b 20 44 65 |iv of Mu|nich; De|
|00004f50| 75 74 73 63 68 65 73 20 | 48 65 72 7a 7a 65 6e 74 |utsches |Herzzent|
|00004f60| 72 75 6d 2c 20 4d 75 6e | 69 63 68 2c 20 47 65 72 |rum, Mun|ich, Ger|
|00004f70| 6d 61 6e 79 29 0d 0a 4a | 20 43 6f 6d 70 75 74 20 |many)..J| Comput |
|00004f80| 41 73 73 69 73 74 20 54 | 6f 6d 6f 67 72 20 31 33 |Assist T|omogr 13|
|00004f90| 3a 36 32 31 2d 36 32 36 | 2c 20 31 39 38 39 0d 0a |:621-626|, 1989..|
|00004fa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fb0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fe0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00004ff0| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct....  |
|00005000| 20 20 20 45 63 68 6f 63 | 61 72 64 69 6f 67 72 61 |   Echoc|ardiogra|
|00005010| 70 68 79 20 68 61 73 20 | 69 6e 63 72 65 61 73 65 |phy has |increase|
|00005020| 64 20 74 68 65 20 64 65 | 74 65 63 74 69 6f 6e 20 |d the de|tection |
|00005030| 6f 66 20 63 61 72 64 69 | 61 63 20 74 75 6d 6f 72 |of cardi|ac tumor|
|00005040| 73 2c 20 61 6c 74 68 6f | 75 67 68 0d 0a 74 68 65 |s, altho|ugh..the|
|00005050| 73 65 20 74 75 6d 6f 72 | 73 20 73 74 69 6c 6c 20 |se tumor|s still |
|00005060| 70 72 65 73 65 6e 74 20 | 61 20 64 69 61 67 6e 6f |present |a diagno|
|00005070| 73 74 69 63 20 63 68 61 | 6c 6c 65 6e 67 65 2e 20 |stic cha|llenge. |
|00005080| 20 54 6f 20 61 73 73 65 | 73 73 20 74 68 65 20 63 | To asse|ss the c|
|00005090| 6f 6e 74 72 69 62 75 74 | 69 6f 6e 0d 0a 6f 66 20 |ontribut|ion..of |
|000050a0| 4d 52 49 20 74 6f 20 74 | 68 65 20 73 74 75 64 79 |MRI to t|he study|
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|000050e0| 20 61 20 66 61 6d 69 6c | 79 0d 0a 68 69 73 74 6f | a famil|y..histo|
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|00005180| 65 72 65 64 20 4d 52 49 | 2e 20 20 4f 66 20 74 68 |ered MRI|.  Of th|
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|00005230| 65 6e 67 74 68 20 6f 66 | 20 31 20 54 2e 20 20 56 |ength of| 1 T.  V|
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|00005250| 6f 66 20 74 75 6d 6f 72 | 73 20 77 65 72 65 20 64 |of tumor|s were d|
|00005260| 65 6d 6f 6e 73 74 72 61 | 74 65 64 20 6f 6e 20 4d |emonstra|ted on M|
|00005270| 52 49 20 69 6e 20 37 20 | 70 61 74 69 65 6e 74 73 |RI in 7 |patients|
|00005280| 20 28 46 69 67 20 36 2d | 32 32 29 2e 20 20 54 75 | (Fig 6-|22).  Tu|
|00005290| 6d 6f 72 73 20 72 61 6e | 67 65 64 0d 0a 62 65 74 |mors ran|ged..bet|
|000052a0| 77 65 65 6e 20 2e 35 20 | 61 6e 64 20 34 20 63 6d |ween .5 |and 4 cm|
|000052b0| 20 69 6e 20 64 69 61 6d | 65 74 65 72 2e 20 20 4e | in diam|eter.  N|
|000052c0| 6f 20 63 61 72 64 69 61 | 63 20 74 75 6d 6f 72 73 |o cardia|c tumors|
|000052d0| 20 77 65 72 65 20 66 6f | 75 6e 64 20 62 79 20 4d | were fo|und by M|
|000052e0| 52 49 20 69 6e 20 32 0d | 0a 70 61 74 69 65 6e 74 |RI in 2.|.patient|
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|00005360| 73 63 65 6e 64 69 6e 67 | 20 61 72 74 65 72 79 20 |scending| artery |
|00005370| 61 6e 67 69 6f 6d 61 20 | 77 69 74 68 0d 0a 73 75 |angioma |with..su|
|00005380| 62 65 70 69 63 61 72 64 | 69 61 6c 20 62 6c 65 65 |bepicard|ial blee|
|00005390| 64 69 6e 67 2e 0d 0a 20 | 20 20 20 20 45 63 68 6f |ding... |    Echo|
|000053a0| 63 61 72 64 69 6f 67 72 | 61 70 68 79 20 64 65 74 |cardiogr|aphy det|
|000053b0| 65 63 74 65 64 20 31 35 | 20 69 6e 74 72 61 6d 75 |ected 15| intramu|
|000053c0| 72 61 6c 20 74 75 6d 6f | 72 73 2c 20 6f 6e 6c 79 |ral tumo|rs, only|
|000053d0| 20 32 20 6f 66 20 77 68 | 69 63 68 20 77 65 72 65 | 2 of wh|ich were|
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|000053f0| 4d 52 49 2e 20 20 4f 6e | 6c 79 20 31 38 20 6f 66 |MRI.  On|ly 18 of|
|00005400| 20 74 68 65 20 33 31 20 | 69 6e 74 72 61 63 61 76 | the 31 |intracav|
|00005410| 69 74 61 72 79 20 74 75 | 6d 6f 72 73 20 76 69 73 |itary tu|mors vis|
|00005420| 75 61 6c 69 7a 65 64 20 | 62 79 0d 0a 65 63 68 6f |ualized |by..echo|
|00005430| 63 61 72 64 69 6f 67 72 | 61 70 68 79 20 77 65 72 |cardiogr|aphy wer|
|00005440| 65 20 69 64 65 6e 74 69 | 66 69 65 64 20 77 69 74 |e identi|fied wit|
|00005450| 68 20 4d 52 49 20 28 74 | 61 62 6c 65 29 2e 20 20 |h MRI (t|able).  |
|00005460| 54 68 65 20 74 75 6d 6f | 72 73 20 6f 6e 20 4d 52 |The tumo|rs on MR|
|00005470| 49 20 77 65 72 65 20 61 | 6c 6c 0d 0a 72 68 61 62 |I were a|ll..rhab|
|00005480| 64 6f 6d 79 6f 6d 61 73 | 20 62 75 6c 67 69 6e 67 |domyomas| bulging|
|00005490| 20 69 6e 74 6f 20 74 68 | 65 20 63 61 72 64 69 61 | into th|e cardia|
|000054a0| 63 20 63 61 76 69 74 69 | 65 73 20 61 6e 64 20 77 |c caviti|es and w|
|000054b0| 65 72 65 20 6c 65 73 73 | 20 74 68 61 6e 20 2e 35 |ere less| than .5|
|000054c0| 20 63 6d 20 69 6e 0d 0a | 64 69 61 6d 65 74 65 72 | cm in..|diameter|
|000054d0| 2e 20 20 4d 61 67 6e 65 | 74 69 63 20 72 65 73 6f |.  Magne|tic reso|
|000054e0| 6e 61 6e 63 65 20 69 6d | 61 67 69 6e 67 20 77 61 |nance im|aging wa|
|000054f0| 73 20 61 62 6c 65 20 74 | 6f 20 64 65 6d 6f 6e 73 |s able t|o demons|
|00005500| 74 72 61 74 65 20 33 20 | 61 64 64 69 74 69 6f 6e |trate 3 |addition|
|00005510| 61 6c 0d 0a 69 6e 74 72 | 61 63 61 76 69 74 79 20 |al..intr|acavity |
|00005520| 74 75 6d 6f 72 73 20 6e | 6f 74 20 64 65 74 65 63 |tumors n|ot detec|
|00005530| 74 65 64 20 77 69 74 68 | 20 65 63 68 6f 63 61 72 |ted with| echocar|
|00005540| 64 69 6f 67 72 61 70 68 | 79 2e 0d 0a 20 20 20 20 |diograph|y...    |
|00005550| 20 43 61 72 64 69 61 63 | 20 74 75 6d 6f 72 73 20 | Cardiac| tumors |
|00005560| 6d 61 79 20 76 61 72 79 | 20 69 6e 20 73 69 7a 65 |may vary| in size|
|00005570| 2c 20 6c 6f 63 61 74 69 | 6f 6e 2c 20 61 6e 64 20 |, locati|on, and |
|00005580| 73 79 6d 70 74 6f 6d 73 | 2e 20 20 53 6f 6d 65 20 |symptoms|.  Some |
|00005590| 70 61 74 69 65 6e 74 73 | 0d 0a 6d 61 79 20 72 65 |patients|..may re|
|000055a0| 6d 61 69 6e 20 61 73 79 | 6d 70 74 6f 6d 61 74 69 |main asy|mptomati|
|000055b0| 63 20 66 6f 72 20 6c 6f | 6e 67 20 70 65 72 69 6f |c for lo|ng perio|
|000055c0| 64 73 20 6f 66 20 74 69 | 6d 65 2e 20 20 54 68 65 |ds of ti|me.  The|
|000055d0| 20 66 69 72 73 74 20 64 | 69 61 67 6e 6f 73 74 69 | first d|iagnosti|
|000055e0| 63 20 74 6f 6f 6c 0d 0a | 69 6e 20 70 61 74 69 65 |c tool..|in patie|
|000055f0| 6e 74 73 20 77 69 74 68 | 20 73 75 73 70 65 63 74 |nts with| suspect|
|00005600| 65 64 20 74 75 6d 6f 72 | 73 20 73 68 6f 75 6c 64 |ed tumor|s should|
|00005610| 20 62 65 20 65 63 68 6f | 63 61 72 64 69 6f 67 72 | be echo|cardiogr|
|00005620| 61 70 68 79 2e 20 20 4d | 61 67 6e 65 74 69 63 0d |aphy.  M|agnetic.|
|00005630| 0a 72 65 73 6f 6e 61 6e | 63 65 20 69 6d 61 67 69 |.resonan|ce imagi|
|00005640| 6e 67 20 69 73 20 73 75 | 70 65 72 69 6f 72 20 69 |ng is su|perior i|
|00005650| 6e 20 64 65 6c 69 6e 65 | 61 74 69 6f 6e 20 6f 66 |n deline|ation of|
|00005660| 20 74 68 65 20 69 6e 74 | 72 61 2d 20 61 6e 64 20 | the int|ra- and |
|00005670| 65 78 74 72 61 63 61 72 | 64 69 61 63 0d 0a 65 78 |extracar|diac..ex|
|00005680| 74 65 6e 73 69 6f 6e 20 | 6f 66 20 6e 6f 6e 72 68 |tension |of nonrh|
|00005690| 61 62 64 6f 6d 79 6f 6d | 61 6c 20 74 75 6d 6f 72 |abdomyom|al tumor|
|000056a0| 73 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |s.....Po|st-Comme|
|000056b0| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 43 61 72 64 69 |nt....  |   Cardi|
|000056c0| 61 63 20 74 75 6d 6f 72 | 73 20 61 72 65 20 6e 6f |ac tumor|s are no|
|000056d0| 74 20 63 6f 6d 6d 6f 6e | 6c 79 20 65 6e 63 6f 75 |t common|ly encou|
|000056e0| 6e 74 65 72 65 64 20 69 | 6e 20 74 68 65 20 70 65 |ntered i|n the pe|
|000056f0| 64 69 61 74 72 69 63 20 | 70 61 74 69 65 6e 74 2e |diatric |patient.|
|00005700| 0d 0a 54 68 69 73 20 70 | 61 70 65 72 20 69 73 20 |..This p|aper is |
|00005710| 61 6e 20 65 78 63 65 6c | 6c 65 6e 74 20 67 75 69 |an excel|lent gui|
|00005720| 64 65 20 74 6f 20 74 68 | 65 20 64 69 61 67 6e 6f |de to th|e diagno|
|00005730| 73 74 69 63 20 77 6f 72 | 6b 2d 75 70 20 6f 66 20 |stic wor|k-up of |
|00005740| 74 68 6f 73 65 20 69 6e | 20 77 68 6f 6d 0d 0a 73 |those in| whom..s|
|00005750| 75 63 68 20 61 20 6c 65 | 73 69 6f 6e 20 69 73 20 |uch a le|sion is |
|00005760| 73 75 73 70 65 63 74 65 | 64 2e 20 20 49 6e 63 69 |suspecte|d.  Inci|
|00005770| 64 65 6e 74 61 6c 6c 79 | 2c 20 74 68 65 20 69 6d |dentally|, the im|
|00005780| 61 67 65 73 20 66 72 6f | 6d 20 4d 52 49 20 69 6e |ages fro|m MRI in|
|00005790| 20 74 68 65 20 6f 72 69 | 67 69 6e 61 6c 0d 0a 70 | the ori|ginal..p|
|000057a0| 61 70 65 72 20 61 72 65 | 20 65 78 63 65 6c 6c 65 |aper are| excelle|
|000057b0| 6e 74 2e 2d 2d 4a 2e 41 | 2e 20 4b 69 72 6b 70 61 |nt.--J.A|. Kirkpa|
|000057c0| 74 72 69 63 6b 2c 20 4a | 72 2e 2c 20 4d 2e 44 2e |trick, J|r., M.D.|
|000057d0| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|000057e0| 30 30 37 30 37 7d 0d 0a | 24 54 69 74 6c 65 7b 45 |00707}..|$Title{E|
|000057f0| 76 61 6c 75 61 74 69 6f | 6e 20 6f 66 20 50 75 6c |valuatio|n of Pul|
|00005800| 6d 6f 6e 61 72 79 20 41 | 72 74 65 72 69 61 6c 20 |monary A|rterial |
|00005810| 4d 6f 72 70 68 6f 6c 6f | 67 79 20 69 6e 20 43 79 |Morpholo|gy in Cy|
|00005820| 61 6e 6f 74 69 63 20 43 | 6f 6e 67 65 6e 69 74 61 |anotic C|ongenita|
|00005830| 6c 0d 0a 48 65 61 72 74 | 20 44 69 73 65 61 73 65 |l..Heart| Disease|
|00005840| 20 62 79 20 4d 61 67 6e | 65 74 69 63 20 52 65 73 | by Magn|etic Res|
|00005850| 6f 6e 61 6e 63 65 20 49 | 6d 61 67 69 6e 67 7d 0d |onance I|maging}.|
|00005860| 0a 24 41 75 74 68 6f 72 | 7b 0d 0a 43 61 6e 74 65 |.$Author|{..Cante|
|00005870| 72 2c 20 43 45 0d 0a 47 | 75 74 69 65 72 72 65 7a |r, CE..G|utierrez|
|00005880| 2c 20 46 52 0d 0a 4d 69 | 72 6f 77 69 74 7a 2c 20 |, FR..Mi|rowitz, |
|00005890| 53 41 0d 0a 4d 61 72 74 | 69 6e 2c 20 54 43 0d 0a |SA..Mart|in, TC..|
|000058a0| 48 61 72 74 6d 61 6e 6e | 2c 20 41 46 2c 20 4a 72 |Hartmann|, AF, Jr|
|000058b0| 7d 0d 0a 24 41 66 66 69 | 6c 69 61 74 69 6f 6e 7b |}..$Affi|liation{|
|000058c0| 57 61 73 68 69 6e 67 74 | 6f 6e 20 55 6e 69 76 3b |Washingt|on Univ;|
|000058d0| 20 53 74 20 4c 6f 75 69 | 73 20 43 68 69 6c 64 72 | St Loui|s Childr|
|000058e0| 65 6e 27 73 20 48 6f 73 | 70 3b 20 4a 65 77 69 73 |en's Hos|p; Jewis|
|000058f0| 68 20 48 6f 73 70 2c 20 | 53 74 20 4c 6f 75 69 73 |h Hosp, |St Louis|
|00005900| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 41 6d 20 48 |}..$Jour|nal{Am H|
|00005910| 65 61 72 74 20 4a 7d 0d | 0a 24 56 6f 6c 75 6d 65 |eart J}.|.$Volume|
|00005920| 7b 31 31 38 7d 0d 0a 24 | 50 61 67 65 7b 33 34 37 |{118}..$|Page{347|
|00005930| 2d 33 35 34 7d 0d 0a 24 | 44 61 74 65 7b 31 39 38 |-354}..$|Date{198|
|00005940| 39 7d 0d 0a 24 59 42 56 | 6f 6c 7b 31 39 39 31 20 |9}..$YBV|ol{1991 |
|00005950| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 44 69 61 |Year Boo|k of Dia|
|00005960| 67 6e 6f 73 74 69 63 20 | 52 61 64 69 6f 6c 6f 67 |gnostic |Radiolog|
|00005970| 79 7d 0d 0a 24 43 68 61 | 70 74 65 72 7b 36 2d 33 |y}..$Cha|pter{6-3|
|00005980| 39 7d 0d 0a 24 59 42 45 | 64 69 74 6f 72 7b 44 72 |9}..$YBE|ditor{Dr|
|00005990| 73 2e 20 48 65 6e 64 65 | 65 2c 20 4b 65 61 74 73 |s. Hende|e, Keats|
|000059a0| 2c 20 4b 69 72 6b 70 61 | 74 72 69 63 6b 2c 20 4d |, Kirkpa|trick, M|
|000059b0| 69 6c 6c 65 72 2c 20 4f | 73 62 6f 72 6e 2c 20 52 |iller, O|sborn, R|
|000059c0| 65 65 64 2c 20 61 6e 64 | 20 54 68 6f 6d 70 73 6f |eed, and| Thompso|
|000059d0| 6e 7d 0d 0a 24 54 61 62 | 6c 65 7b 54 61 62 6c 65 |n}..$Tab|le{Table|
|000059e0| 20 4f 6d 69 74 74 65 64 | 7d 0d 0a 24 43 6f 6d 6d | Omitted|}..$Comm|
|000059f0| 65 6e 74 61 74 6f 72 7b | 7d 0d 0a 0d 0a 43 6f 70 |entator{|}....Cop|
|00005a00| 79 72 69 67 68 74 20 28 | 43 29 20 59 65 61 72 20 |yright (|C) Year |
|00005a10| 42 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |Book Med|ical Pub|
|00005a20| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 20 31 39 |lishers,| Inc. 19|
|00005a30| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|00005a40| 42 6f 6f 6b 20 6f 66 20 | 44 69 61 67 6e 6f 73 74 |Book of |Diagnost|
|00005a50| 69 63 20 52 61 64 69 6f | 6c 6f 67 79 0d 0a 0d 0a |ic Radio|logy....|
|00005a60| 43 68 61 70 74 65 72 20 | 36 20 2d 2d 20 50 65 64 |Chapter |6 -- Ped|
|00005a70| 69 61 74 72 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |iatric R|adiology|
|00005a80| 0d 0a 0d 0a 54 68 6f 72 | 61 78 0d 0a 0d 0a 2d 2d |....Thor|ax....--|
|00005a90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005aa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ab0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ac0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ad0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 45 76 |--------|----..Ev|
|00005ae0| 61 6c 75 61 74 69 6f 6e | 20 6f 66 20 50 75 6c 6d |aluation| of Pulm|
|00005af0| 6f 6e 61 72 79 20 41 72 | 74 65 72 69 61 6c 20 4d |onary Ar|terial M|
|00005b00| 6f 72 70 68 6f 6c 6f 67 | 79 20 69 6e 20 43 79 61 |orpholog|y in Cya|
|00005b10| 6e 6f 74 69 63 20 43 6f | 6e 67 65 6e 69 74 61 6c |notic Co|ngenital|
|00005b20| 20 48 65 61 72 74 0d 0a | 44 69 73 65 61 73 65 20 | Heart..|Disease |
|00005b30| 62 79 20 4d 61 67 6e 65 | 74 69 63 20 52 65 73 6f |by Magne|tic Reso|
|00005b40| 6e 61 6e 63 65 20 49 6d | 61 67 69 6e 67 0d 0a 0d |nance Im|aging...|
|00005b50| 0a 43 61 6e 74 65 72 20 | 43 45 3b 20 47 75 74 69 |.Canter |CE; Guti|
|00005b60| 65 72 72 65 7a 20 46 52 | 3b 20 4d 69 72 6f 77 69 |errez FR|; Mirowi|
|00005b70| 74 7a 20 53 41 3b 20 4d | 61 72 74 69 6e 20 54 43 |tz SA; M|artin TC|
|00005b80| 3b 20 48 61 72 74 6d 61 | 6e 6e 20 41 46 20 4a 72 |; Hartma|nn AF Jr|
|00005b90| 0d 0a 28 57 61 73 68 69 | 6e 67 74 6f 6e 20 55 6e |..(Washi|ngton Un|
|00005ba0| 69 76 3b 20 53 74 20 4c | 6f 75 69 73 20 43 68 69 |iv; St L|ouis Chi|
|00005bb0| 6c 64 72 65 6e 27 73 20 | 48 6f 73 70 3b 20 4a 65 |ldren's |Hosp; Je|
|00005bc0| 77 69 73 68 20 48 6f 73 | 70 2c 20 53 74 20 4c 6f |wish Hos|p, St Lo|
|00005bd0| 75 69 73 29 0d 0a 41 6d | 20 48 65 61 72 74 20 4a |uis)..Am| Heart J|
|00005be0| 20 31 31 38 3a 33 34 37 | 2d 33 35 34 2c 20 31 39 | 118:347|-354, 19|
|00005bf0| 38 39 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |89..----|--------|
|00005c00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005c10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005c20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005c30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005c40| 2d 2d 0d 0a 0d 0a 41 62 | 73 74 72 61 63 74 0d 0a |--....Ab|stract..|
|00005c50| 0d 0a 20 20 20 20 20 41 | 62 6e 6f 72 6d 61 6c 69 |..     A|bnormali|
|00005c60| 74 69 65 73 20 6f 66 20 | 74 68 65 20 70 75 6c 6d |ties of |the pulm|
|00005c70| 6f 6e 61 72 79 20 61 72 | 74 65 72 69 65 73 20 61 |onary ar|teries a|
|00005c80| 72 65 20 63 6f 6d 6d 6f | 6e 6c 79 20 61 73 73 6f |re commo|nly asso|
|00005c90| 63 69 61 74 65 64 20 77 | 69 74 68 0d 0a 63 79 61 |ciated w|ith..cya|
|00005ca0| 6e 6f 74 69 63 20 63 6f | 6e 67 65 6e 69 74 61 6c |notic co|ngenital|
|00005cb0| 20 68 65 61 72 74 20 64 | 69 73 65 61 73 65 2e 20 | heart d|isease. |
|00005cc0| 20 41 6e 67 69 6f 67 72 | 61 70 68 79 20 69 73 20 | Angiogr|aphy is |
|00005cd0| 75 73 75 61 6c 6c 79 20 | 70 65 72 66 6f 72 6d 65 |usually |performe|
|00005ce0| 64 20 74 6f 20 61 73 73 | 65 73 73 0d 0a 74 68 65 |d to ass|ess..the|
|00005cf0| 20 61 6e 61 74 6f 6d 79 | 20 6f 66 20 74 68 65 73 | anatomy| of thes|
|00005d00| 65 20 61 72 74 65 72 69 | 65 73 2e 20 20 48 6f 77 |e arteri|es.  How|
|00005d10| 65 76 65 72 2c 20 6d 6f | 73 74 20 6f 66 20 74 68 |ever, mo|st of th|
|00005d20| 65 20 70 61 6c 6c 69 61 | 74 69 76 65 20 61 6e 64 |e pallia|tive and|
|00005d30| 20 72 65 70 61 72 61 74 | 69 76 65 0d 0a 73 75 72 | reparat|ive..sur|
|00005d40| 67 65 72 79 20 66 6f 72 | 20 74 68 65 73 65 20 64 |gery for| these d|
|00005d50| 65 66 65 63 74 73 20 69 | 73 20 70 65 72 66 6f 72 |efects i|s perfor|
|00005d60| 6d 65 64 20 69 6e 20 69 | 6e 66 61 6e 74 73 20 61 |med in i|nfants a|
|00005d70| 6e 64 20 79 6f 75 6e 67 | 20 63 68 69 6c 64 72 65 |nd young| childre|
|00005d80| 6e 2c 0d 0a 73 75 67 67 | 65 73 74 69 6e 67 20 61 |n,..sugg|esting a|
|00005d90| 20 6e 65 65 64 20 66 6f | 72 20 61 20 6e 6f 6e 69 | need fo|r a noni|
|00005da0| 6e 76 61 73 69 76 65 20 | 6d 65 74 68 6f 64 20 6f |nvasive |method o|
|00005db0| 66 20 65 76 61 6c 75 61 | 74 69 6e 67 20 74 68 65 |f evalua|ting the|
|00005dc0| 20 70 75 6c 6d 6f 6e 61 | 72 79 0d 0a 61 72 74 65 | pulmona|ry..arte|
|00005dd0| 72 69 65 73 2e 20 20 54 | 68 65 20 76 61 6c 75 65 |ries.  T|he value|
|00005de0| 20 6f 66 20 4d 52 49 20 | 69 6e 20 61 73 73 65 73 | of MRI |in asses|
|00005df0| 73 6d 65 6e 74 20 6f 66 | 20 70 75 6c 6d 6f 6e 61 |sment of| pulmona|
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|00005ed0| 20 63 79 61 6e 6f 74 69 | 63 20 68 65 61 72 74 20 | cyanoti|c heart |
|00005ee0| 64 69 73 65 61 73 65 20 | 61 6e 64 0d 0a 64 65 63 |disease |and..dec|
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|000060c0| 2e 20 20 48 6f 77 65 76 | 65 72 2c 20 4d 52 49 20 |.  Howev|er, MRI |
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|000062f0| 20 70 6c 61 6e 6e 69 6e | 67 20 6f 66 20 74 68 65 | plannin|g of the|
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|000063b0| 20 66 6f 72 20 74 68 65 | 20 41 73 73 65 73 73 6d | for the| Assessm|
|000063c0| 65 6e 74 20 6f 66 0d 0a | 43 6f 61 72 63 74 61 74 |ent of..|Coarctat|
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+--------+-------------------------+-------------------------+--------+--------+