Dr. Zamboni talked about fusion imaging again, as he did at ISET.
FUSION IMAGING TECHNOLOGY FOR INTRACRANIAL
http://ccsvism.xoom.it/ISNVD/Abstract-Z ... Fusion.pdf
Paolo Zamboni, MD
, Erica Menegatti, PhD
, Gisela Viselner MD
Fabrizio Calliada MD
, Stefano Bastianello,MD
Vascular Disease Center, University of Ferrara, Ferrara, Italy.
Fondazione Istituto Neurologico Nazionale Casimiro Mondino, Neuroradiological
Department, University of Pavia, Italy.
IRCCS Policlinico “S. Matteo”, Department of Radiology, University of Pavia, Italy
PURPOSE: Transcranial color coded sonography (TCCS), despite the poor definition
of the anatomical details, permits to investigate the cerebral venous flow in different
postural and respiratory conditions related to the physiology of cerebral venous return.
Usual TCCS windows do not permit to insonate the cavernous and petrosal sinuses. The
aim of this study is to investigate the possibility to insonate these sinuses through a
novel trans-cranial approach, the condylar window.
MATERIALS AND METHODS: We investigated 5 subjects by the means of fusion
imaging technology, an advanced ultrasonographic technique consistently used to
combine ultrasounds and MRI in different districts of the human body, but never used
for studying the brain circulation. Fiducial markers have been placed on the forefront of
each patient before the acquisition of MR brain imaging using a 1.5 T scanner.
Subsequently, the subjects underwent TCCS performed with the Esaote MyLab70XVG
ultrasound scanner equipped with Virtual Navigator technology. Venous circulation has
been investigated by using the classic trans-temporal window and the novel
RESULTS: In all subjects fusion imaging technology demonstrates the possibility to
insonate the cavernous sinus and some of the petrosal sinuses through the condylar
window. In addition, the insonation of the Rosenthal and other parenchymal veins
through the classic trans-temporal window, never validated vs MRI in TCCS study, has
been confirmed by this technology.
CONCLUSION: The condylar window can be used for the study of intracranial deep
cerebral venous system and be useful in clinical practice.
With the decision to not include the deep cerebral veins as part of the doppler ultrasound criteria (the criteria are down to four now, instead of five; it's like when Pluto got dropped as a planet), there is obviously a need for better imaging of reflux in the deep cerebral veins. Perhaps fusion imaging is it?