Indeed ultrasound techniques have a high dynamicity, and therefore a good temporal resolution and neuroradiological techniques have a high anatomic definition, and therefore a good spatial resolution. The possibility of combining

the ultrasound examination with a reference modality in real time allows confirming the anatomical assumption of a new approach. Moreover the identification of vessel segments (TS in this case) is faster and more reliable. This system is a Virtual Navigator software, already used in other body districts. Therefore, after the identification and the proposal of an extended ipsilateral insonation for the TS an imaging fusion system was implemented and tested validating it. Forty consecutive subjects (28 men and 12 women, mean Venetoclax nmr age 55.63 ± 7.61 years) were chosen among patients who underwent standard TCCS examinations at our lab and had – age >18 years; All subjects have not a disease of the venous system and the reasons why they underwent brain MR were migraine or dizziness or a control examination of a previously known nonspecific lesion pattern in the white matter or previous ischemic stroke in the arterial circulation.

The basal TCCS examination was performed by using a MyLab 60 equipment and both the contralateral and the ipsilateral approach were selleck kinase inhibitor used for the insonation of the TS. The Progesterone first 20 subjects underwent a further study with the Virtual Navigator software in order to validate the ipsilateral approach. Fig. 1 shows an example of the contralateral and ipsilateral approach to the TS. It is notable that the proposed insonation plane for the ipsilateral TS, with a more anterior positioning of the probe and an opposite tilting, as compared to the contralateral approach, allows a larger field of view,

and therefore an examination of a greater extent of TS. The increased field of view led us to distinguish three segments of the TS through an ipsilateral approach, as shown in Fig. 2, because of the visualization of the entire course of the TS in the correspondent bone groove. All segments were looked for during the basal TCCS and during the Virtual Navigator examination, and separated insonation rates were calculated. Therefore, the global insonation rate of the TS is composed: – for the contralateral approach by the insonation of the proximal segment; so potentially increasing the rate of success in the TCCS insonation of the TS. Considering both sides, 80 TS were insonated with both contralateral and ipsilateral approach. Insontation rates were compared by using the Fisher exact test.