The insonation rates of the main cerebral veins reported in the literature PI3K inhibitor by using TCCS are [1] and [2]: – BVR 84–93% We planned this preliminary approach with the Virtual Navigator system to verify the feasibility of this strategy to increase the

insonation rate of the main basal cerebral veins. Fifteen consecutive subjects (7 men and 8 women, mean age 51.5 ± 8.64 years) were chosen among patients who underwent standard TCCS examinations at our lab and had – age >18 years All subjects did not have a disease of the venous system and the reasons why they underwent MRI were mainly migraine or dizziness or a control examination of a previously known nonspecific lesion pattern in the white matter. All patients underwent a basal TCCS examination and a subsequent TCCS examination with the Virtual Navigator system. The axial scanning approach was used

by TCCS from the temporal window, according to the validated scanning planes for the venous study, for the insonation of the BVR, GV, SRS and TS [2], [3], [4] and [5]. According to the reference data from the literature, check details only the contralateral approach to the TS was used for this evaluation. A schematic drawing of the assessed cerebral veins and sinuses with the corresponding TCCS images is shown in Fig. 1. The insonation rate of the BVR, GV, SRS and TS were registered both for the basal examination and for the Virtual Navigator system examination and they were compared by Mantel–Haenszel Chi-square for trend. Virtual

Navigator is a MyLab optional license from Esaote, that provides additional image information from a second modality like CT or MR, during a clinical ultrasound session. By using the second modality the user gains security in assessing the morphology of the ultrasound image. The Virtual Navigator system is inserted into a commercially available ultrasound machine and its use involved some sequential steps. First, the MR study was uploaded in the ultrasound platform and the Virtual Navigation software was Edoxaban activated. Second, the ultrasound examination was started and matched with the MR images by using a magnetic tracking system, solidary with the ultrasound probe, along a reference alignment plane. Third, the standard TCCS examination was compared with the Virtual Navigator examination, according to the validated scanning planes for the venous study, for the insonation rate of the BVR, GV, SRS and TS [2] and [5]. The exam steps are summarized as follows: – CT/MR acquisition In Fig. 2 there is an example of the Virtual Navigator application for the arterial circulation and in Fig. 3 the practical steps of the examination are illustrated for the venous examination.