Ah, .NET based anticheat? Alright then.
First, you'll need a .NET based launcher/patcher that requires admin privileges to start. Make sure that the game client only starts through the launcher, and not through any other method.
Then, right before the game starts, start the anticheat. Make sure to start it with specific parameters. If the game tries to start when the anticheat should be open, but the anticheat is nowhere to be found, then don't start the game.
Have the anticheat application close instantly if it is not started with the correct parameters[that only the launcher knows].
If the game closes, detect it in the anticheat and close the anticheat.
Have the anticheat do whatever anticheat measures it does(i.e. look for processes in the background).
Every couple minutes, the anticheat should phone home and tell the server that it is open. The server should similarly look for this 'phone home' at the same interval of time. If the anticheat has not phoned home, then disconnect the user from the server and log it [so you can ban/question them later if you want].
You can also use a second application that detects if the main anticheat or game have closed. If so, it kills off all the anticheat and game processes instantly. Apply similar functionality to the main anticheat. This will help prevent killing the anticheat through task manager, but it won't prevent more intelligent users killing off both anticheat processes simultaneously, and thus the game won't close.
If you can, don't allow the game client to log you in or/and run unless the other processes[anticheat] are open and have correct md5 hashes.
Do note that most of this description comes from when I was working on a anticheat-like application for a private server on VB.Net[maybe C#]. That was a while ago, and I haven't had a need for an anticheat since, so the information here may not be the best way to do things; in fact, it probably is not.
Do note that you will need to create your own custom launcher (and obviously anticheat) with this method, and you will need access to the inner workings of the client and server, at least enough to do what is described in this thread.
G'luck.