title: Comparison of brain vessel imaging from transtemporal and transcondylar approaches using contrast-enhanced transcranial color-coded duplex sonography and Virtual Navigator.
abstract: OBJECTIVE
  The transcondylar approach is a new and used for detection of chronic cerebro-spinal venous insufficiency (CCSVI) and intracranial venous reflux in patients with multiple sclerosis. The aim of this study was to assess the ability of native and contrast enhanced (CE-) transcranial color-coded duplex sonography (TCCS) to detect flow and reflux in deep cerebral veins and intracranial venous sinuses from transcondylar and transtemporal approaches.
  
  
  METHODS
  Brain magnetic resonance imaging and TCCS from transtemporal and transcondylar approaches using the new technology - Fusion Imaging - in 8 volunteers and 5 patients with multiple sclerosis.
  
  
  RESULTS
  Using TCCS and CE-TCCS, the arteries of the circle of Willis could be detected from the transtemporal approach in 13/13 subjects in both examinations, while detection of the venous system was possible in 7/13 and 9/13 subjects, respectively. However, the arteries of the circle of Willis and venous system were detected through the transcondylar approach in only 5/13 (P=0.041) and 1/13 (P=0.031) subjects using TCCS, and in 12/13 (P=0.921) and 7/13 (P=0.687) subjects using CE-TCCS, respectively.
  
  
  CONCLUSIONS
  The results reveal that the TCCS transcondylar approach has serious limitations for the standard detection of intracranial venous reflux.
authors.affiliation: Department of Neurology, University Hospital, Ostrava, Czech Republic.|Department of Nursing, Faculty of Health Science, Palacky University Olomouc and University Hospital Olomouc.|Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc.
authors.forename: David
authors.initials: D
authors.lastname: Skoloudik
authors.affiliation: Department of Neurology, University Hospital, Ostrava, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Kuliha
authors.affiliation: Department of Neurology, University Hospital, Ostrava, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Roubec
authors.affiliation: Department of Radiology, University Hospital, Ostrava.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Havelka
authors.affiliation: Department of Biophysics, Faculty of Medicine and Dentistry and Institute of Molecular and Translational Medicine, Palacky University Olomouc.
authors.forename: Katerina
authors.initials: K
authors.lastname: Langova
authors.affiliation: Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc.
authors.forename: Roman
authors.initials: R
authors.lastname: Herzig
mesh_terms: D000328:Adult; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002908:Chronic Disease; D003287:Contrast Media; D003392:Cranial Sinuses / Q000000981:diagnostic imaging*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods; D014689:Venous Insufficiency / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Virtual Navigator; fusion imaging; magnetic resonance imaging; reflux; ultrasound; venous system