Background: Proton magnetic resonance spectroscopy (MRS) is a well-known device for analyzing the biological fluids metabolically. Obtaining accurate and reliable information via MRS needs a homogeneous magnetic field in order to provide well-defined peaks and uniform water suppression. There are lots of reasons which can disturb the magnetic field homogeneity which can be corrected by a process known as shimming. This study is intended to recall the importance of shimming and also the significant role of quality control (QC) in achieving an accurate quantification. Material and Method: An acrylic cylindrical quality control phantom was designed as an analog of brain MRS test phantoms in order to control the accuracy of the obtained signal of a 1. 5 T Siemens MRI system which belonged to one of Shiraz hospitals. The signal of NAA, Cho, Cr, the combination of these metabolites and also the distilled water, which was used in this study, was evaluated using separate phantoms. A QC test was performed using Siemens QC phantom and a standard test phantom. Results: The spectrum of our home-made phantom had a significant difference with the expected spectrum. The results of checking the spectrum of metabolites separately also confirmed that there was a systemic problem that affects all the signals originated from all metabolites and even the pure distilled water. The MRS system could not pass QC tests, and peak broadening was common in all spectra. The complex spectrum of standard test phantom was not produced successfully by the MRS system. Discussion: By a simple check of the water peak characteristics, lots of information can be obtained, one of which is the status of shimming that has a considerable effect on the accuracy of the spectrum. Thus, performing an automatic or manual shimming is not a criterion of the spectrum accuracy, and performing a periodic quality control using a test phantom by a specialist is necessary. Conclusion: Briefly, the quality control of MRS and all the other clinical device must be taken seriously. Sometimes QC can be the boundary of a right or a wrong decision for the patient.

Background & Aim: Subarachnoid hemorrhage (SAH) resulting from ruptured intracranial aneurysm (IA) is a still major cause of death and disability. Early prediction of outcome after SAH lacks accuracy since there are many factors and uncertainties in the patient’s clinical status. It is essential to determine the severity of SAH for managing the surgical procedures. Statistical techniques cannot processed these uncertainties simply. Fuzzy logic approach can be used as an ef ficient predictor.Methods & Materials/Patients: This study was conducted retrospectively in 423 patients who admitted to Ghaem hospital of Mashhad with the diagnosis of SAH due to IA between December 2012 and April 2016. The patients were assessed by ten significant variables; including World Federation of Neurological Surgeons scale (WFNS), rebleeding before operation, age, severespasm, External Ventricular Drainage (EVD), ischemia, modified Fisher scale (mFisher), infection, hydrocephalus and the operation method whether it was clipping or coiling. The fuzzy system predicts modified Rankine scale (mRs) based on table look up scheme which converts conscious and subconscious knowledge of the expert into fuzzy IF-THEN rules.Results: In this study, 300 patients is used for constructing the fuzzy rule base and 123 patients were assessed for verification of the fuzzy system. Fuzzy logic predictions correl ate with the patients’ real mRs.Conclusion: Accurate and early outcome prediction of the patient is necessary for any medical decision making. It is investigated that the outcome of the patient with IA could be predicted efficiently by fuzzy logic methodology. Thus, this research can pioneer new studies in neurosur gery area.

Background/Objective: In this study, our purpose was to evaluate the thalamic magnetic resonance (MR) spectroscopic changes in multiple sclerosis (MS) patients. Patients and Methods: Forty-three relapsing-remitting MS (RRMS) patients and 23 control subjects were included in this study. Routine brain MR and MR spectroscopy (MRS) using single voxel technique were carried out in all the patients and the controls. The N-Acetylaspartate (NAA), choline (Cho) and creatine (Cr) peaks were calculated. The thalamic relative metabolite ratios of the RRMS patients were compared to those of the control subjects by using the statistical measures (Mann-Whitney U test). The level of statistical significance was set at 0.05.Results: The thalamic NAA/Cr and NAA/Cho ratios were lower while the thalamic Cho/Cr ratio was higher in the MS patients than those of the control subjects. But these differences in the spectroscopic relative metabolite ratios were not statistically significant between the groups (p=0.34, p=0.22 and p=0.1, respectively).Conclusion: The spectroscopic relative metabolite ratios were of limited value in determining the presence of metabolic changes in the deep grey matter of MS patients. New studies about the presence of the deep grey matter damage in MS patients are necessary.