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A device that uses the shear mode of transcranial ultrasound transmission for intraoperative monitoring has been designed, constructed, and tested with 10 human subjects. Magnetic resonance (MR) images were obtained with the device spatially registered to the MR reference coordinates. Peaks in both the ultrasound and MR signals were identified and analyzed both for spatial localization and signal-to-noise ratio (SNR). The first results aimed towards validating the prototype device against MRI have demonstrated excellent correlation (n = 38, R2 = 0.9962) between the structural localization abilities of the two modalities. In addition, the overall SNR of the ultrasound backscatter signals (n = 38, SNR = 25.4plusmn5.2 dB) was statistically equivalent to that of the MR data (n = 38, SNR = 22.5plusmn4.8 dB).