Transcranial ultrasound and magnetic resonance image fusion with virtual navigator

The Virtual Navigator (VN) technology was used for the fusion of transcranial Ultrasound (US) and brain Magnetic Resonance Images (MRI), with a repeatability error under 0.1 cm. The superimposition of US to the previously acquired MRI volume consisted of external point-based registration, that was subsequently refined with image-based registration of internal brain structures. The common registration procedure with the usage of external fiducial markers acquired with the two modalities was improved using facial anatomical landmarks, with a reduction of the internal targeted structure residual shift (maximum 0.7 cm in the cranio-caudal direction). This allowed the investigation of Deep Cerebral Veins and dural sinuses insonated from the condyloid process of the mandible, a recently introduced US window. The fusion of these vessels to the MRI volume provided their anatomical position and helped excluding false Doppler signal sources.