Right-to-left shunt detection via synchronized contrast transcranial Doppler combined with contrast transthoracic echocardiography: A preliminary study

Figure 4 Magnetic resonance imaging of the brain. A and B: Brain magnetic resonance imaging identified a few small ischemic foci in bilateral subcortical areas (arrows); C: At rest, contrast transcranial Doppler shows a small right-to-left shunt (RLS), whereas after the Valsalva maneuver (VM) it shows a large RLS; D and E: Contrast transthoracic echocardiography shows a small and a moderate RLS at rest and after the VM, respectively.