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MINISTRY OF EDUCATION MINISTRY OF AND TRAINING DEFENCE VIETNAM MILITARY MEDICAL UNIVERSITY - PHAM THANH NGUYEN RESEARCH ON MORPHOLOGICAL CHARACTERISTICS OF THALAMUS AND CONNECTION OF THALAMUS – CORTEX IN MRI OF HUMAN BRAIN OF HEALTHY VIETNAMESE ADULTS SPECIALITY: BIOMEDICAL SCIENCE CODE: 9720101 SUMMARY OF THESIS Hanoi - 2021 Scientific works are completed at: MILITARY MEDICAL UNIVERSITY Full name of supervisors: Associate Prof Dr Lam Khanh Prof Dr Nguyen Duy Bac The first opponent: Prof Dr Pham Minh Thong The second opponent: Associate Prof Dr Ngo Xuan Khoa The third opponent: Associate Prof Dr Do Duc Cuong The thesis will be protected before the Board of thesis review at Military Medical University at ……… a.m/ p.m on…………,2021 The thesis can be found at: National Library Library of Military Medical University Imperativeness The thalamus is a complex of gray nuclei located in the brain Recent advances in neural imaging technology have given new insights into the anatomical structure of the human brain and are changing human understanding of the hippocampus It is now possible to differentiate subnuclear structures to examination of functional connections of different areas of the brain through functional magnetic resonance imaging (fMRI), through studies of the brain in autopsy or through animal experiments Investigating the anatomical links in one brain region and among brain regions helps us to understand the functional activities and the coordination of functional activities of those brain regions Research has been conducted on animals using noninvasive methods to learn about the conduction tracts (bundles) in the brain, but studies involving pathways in the human brain are very limited Injecting fluorescent pigments after autopsy allows the transmission bands (bundles) to be identified but only seen at distances about 10 millimeters With further links may be determined by large bundle anatomy or histological study of distal degeneration following a localized lesion, but such studies are based on a relatively small number of The patient has no information The creation of nerve path images by Diffusion Tensor Imaging DTI is based on anisotropic diffusion of water molecules in the axons DTI is a new and modern technique that provides full awareness of the connections in the brain In addition, recent developments in diffuse tension magnetic resonance imaging have enabled us to determine the pathways of the bands (bundles), mainly in the living brain The image of sensory pathways through the thalamus connecting to brain regions is very important in clinical practice and has not been studied in Vietnam The objectives of the study are to: Describe the morphological features of the thalamus on the 3.0 tesla magnetic resonance image in healthy Vietnamese adults Determine morphological characteristics of the thalamus cortex on the 3.0 tesla DTI image in healthy Vietnamese adults Practical meaning and further contributions This thesis provides data of the changes in length, width, height as well as the volume of the right and left thalamus on the 3.0 MRI films in ordinary Vietnamese adults At the same time, this thesis also identifies morphological characteristics: length, number of fibers, FA, ADC of the thalamocortical tracts on magnetic resonance diffusion tensor imaging (DTI) 3.0 in ordinary Vietnamese adults These are valuable scientific data of morphological characteristics of the thalamus and the thalamocortical tracts on MRI 3.0 images in normal Vietnamese adults This is the first study in Vietnam to apply a new and modern technique, which helps to fully understand the links in the brain, the recent development in magnetic resonance diffusion tensor imaging techniques helps us to determine the path of the tracts (bundles), mainly in the living brain STRUCTURE OF THE THESIS The thesis includes: 129 pages Question: pages; Overview: 38 pages; Research subjects and methodology: 18 pages; Research results: 37 pages; Discussion: 31 pages; Conclusion: pages; Recommendation pages The thesis also has 40 Tables, Charts, 35 Figures; 141 References (1 in Vietnamese and 140 in English) CHAPTER LITERATURE REVIEW Anatomical and functional characteristics of the thalamus 1.1 Anatomical characteristics of the thalamus 1.1.1 Outline The thalamus, shaped like an egg, is the two largest gray nuclei of the central gray nuclei and is a major component of the medial cerebrum, together with the hypothalamus forming the side of the third interventriculare The boundary between the two regions is marked by a furrow (hypothalamus) that runs from the foramen interventriculare to the aperture aqueductus cerebri In most individuals, the bilateral thalamus is connected through the thin slit of the third ventricle by adhesion interthalamica, also known as the gray edge 1.1.2 Outward form of the thalamus The thalamus is ovoid, with large heads facing back, the large axis facing forward, inward, and slightly upwards, with the large axis on the opposite side at an angle of about 60 °, extending backwards The thalamus are about 3cm long, 2cm high, 1.5cm thick, with sides: inside, outside, back (upper), abdomen (bottom); heads: front, back; and shores are more or less identified: the inner upper shore, the outer upper shore and the inner lower shore 1.1.3 The inner form of the thalamus 1.1.4 The role of the thalamus The thalamus is the main transition station to the cortex, described as a "gateway" to the cortex Almost everything we can know about the outside world, or about ourselves, is based on information passing through the thalamus 1.1.4.1 Environmental awareness is an activity related to the thalamus 1.1.4.2 The importance of the cerebral cortex - thalamus - cortex for perception 1.1.4.3 Perception to act or action to perceive? Parallel processing of sensory and motor signals 1.2 Neurotransmitters 1.2.1 Sensory nerve pathways 1.2.1.1 Outline of the sensory neurotransmitters 1.2.1.2 Somatic sensory pathways posterior column – medial lemniscus The Dorsal Column-Medial Lemniscal Pathway The dorsal column-medial lemniscal pathway (DCML) carries the sensory modalities of fine touch (tactile sensation), vibration and proprioception There are three groups of neurones involved in this pathway – first, second and third order neurones First Order Neurones Second Order Neurones Third Order Neurones 1.2.1.3 Unconscious Sensation Posterior spinocerebellar tract Anterior spinocerebellar tract 1.2.1.4 The Anterolateral System First Order Neurones Second Order Neurones Third Order Neurones 1.2.2 Descending motor pathways Corticospinal tract 1.3 Diffuse tensor imaging and its application in studying the structure of the thalamus and neurotransmitters 1.3.1 Overview of diffuse tensor imaging and some related factors Method DTI is based on an innovation of the MRI technique, which increases the sensitivity to very small three-dimensional movements of water molecules in the tissue In Cerebrospinal fluid (CSF) the movement of water molecules is isotropic, which means that diffusion is equivalent in all directions, that is, water diffuses freely However, in white matter diffuses in a directional way, also known as anisotropic Due to the structural properties and delineation of myelin in the bundles of nerve fibers, the water molecules in these bundles are confined diffuse along the axons of the bundle of nerve fibers Therefore, DTIs are used to identify and characterize the white matter's conduction bundles and thus can provide researchers with the properties of the connection pathways in the brain 1.3.2 DTI applications in brain structure research 1.3.3 Some methods and initial application of DTI in determining the structural features and nuclei of the thalamus 1.3.4 Determination of the connections of the thalamus to the cortex using DTI 1.3.5 DTI applications in research on the thalamus and neurotransmitters in Vietnam So far, with the available documents, we have only seen the work of authors Nguyen Tri Dung, Pham Ngoc Hoa, and Cao Thien Tuong in 2010 studying the use of DTIs in distinguishing brain abcess from necrotic brain tumors in capsule form There is no research study on morphological characteristics of the hippocampus and the connections of the thalamus with regions of the cerebral cortex by this technique CHAPTER SUBJECTS AND METHODS 2.1 Participants and data acquisition 2.1.1 Location and duration of research This thesis was conducted at the Imaging Department of the 108th Military Central Hospital, from June 2015 to December 2016 2.1.2 Subjects of study This study used data sets and methods of analyzing and filming cranial CHT films of 50 normal people, aged 18 years and older, without any brain diseases or neurological damage Including: - Criteria for selecting research subjects Select the subject without any skull abnormalities; history or currently traumatic brain injury, any diseases that cause central nervous damage such as Alzheimer's, brain tumors, or any neurological, psychiatric and chronic neurological diseases All research subjects were MRI captured with basic pulse sequences and DTI pulses - Exclusion criterias Subjects are excluded from the research if they have one of the diseases such as central neurological damage pathologies, for example, Alzheimer's, brain tumors, or neurological, psychiatric and chronic neurological diseases 2.2 Research methods 2.2.1 Study Design This is a Cross sectional study 2.2.2 Study equipments Achieva 3T resonance imaging machine (Phillips, Netherlands) has 16-channel cranial coil and DWI and DTI imaging software Image Processing Workstation with Extended MR Workspace 2.6.3.1 2.3 Research indicators 2.3.1 General characteristics of the research participants General characteristics: Age, gender 2.3.2 Morphology of thalamus on MRI 3.0 tesla The length of the right and left thalamus (mm) The width of the right and left thalamus (mm) The height of the right and left thalamus (mm) The volume of the right and left thalamus (ml) 2.3.3 Morphology of thalamocortical sensory tract on DTI 3.0 tesla - The number of branches of thalamocortical tracts on the 3D image - The length of thalamocortical tracts on the 3D image The right and left thalamocortical tracts’ dimensions on 3D images: - Types of thalamocortical tract graphs (divided in 2, 3, 4, 5, branches and branches to the opposite side when connected to the cerebral cortex) - FA, ADC values of thalamocortical tracts on 3D image 2.4 Data processing The figures are analyzed according to the biomeded statistical method: Data processing: using SPSS 22.0 software Variables are constantly expressed as means and deviations (X ± SD); median value and percentage (%) The research data is processedand calculated using the t- test algorithm on SPSS software Statistically significant differences are determined when p < 0.05 Analyzes the linear correlation between X and Y variables with a standard distributionwith a Pearson correlationnumber CHAPTER RESULTS 3.1 Age and gender characteristics of research subjects Table 3.1 Statistics on age groups, gender and the corresponding distributions of research subjects Age Age Total 20 – 39 40 - 59 ≥ 60 n n n n Group (%) (%) (%) (%) 14 26 Male (18) (28) (6) (52) 12 24 Female (24) (18) (6) (48) 21 23 50 Total (42) (46) (12) (100) 11 3.2.5 Volumetric characteristics of the thalamus Table 3.9 Comparision between the left and right volumes of the thalamus (ml) ± SD p Gender Volume n Female Left side 24 6.18 ± 0.52 26 6.65 ± 0.43 24 6.19 ± 0.52 26 6.65 ± 0.44 Left side 50 6.42 ± 0.52 Right side 50 6.43 ± 0.53 General 100 12.86 ± 1.06 % left - right difference 50 0.16 ± 0.17 Male Female Right side Male General 0.001 0.001 0.99 Comments: Table 3.9 compares the thalamus volume on the left and right in two genders Overall, it is clear that the volume of the thalamus in male is greater than that of female on both sides, and the difference is statistically significant with p < 0.05 In general, 6.42 ml is the number of the thalamus volume on the left and the number on the right is 6.43 ml Consequently, the volume of the thalamus in both sides are relatively similar The total volume of the thalamus is 12.86 ml 12 3.3 Morphological characteristics of the thalamus - cortex 3.3.1 Characteristics of the size of the thalamus - cortex 3.3.1.1 Characteristics of the length of the cortical thalamus Table 3.20 Length of the thalamus - cortex The length of the thalamus General (2 cortex Group sides) Left Right n 50 50 100 Median 123.14 130.64 126.33 value ± SD 121.21 ± 13.49 130.17 ± 11.44 125.69 ± 13.24 p 0.028 0.001 Comments: The results in Table 3.20 show that the median length of the thalamus- cortex on the right is longer than that of the left side, having statistical significance with p < 0.05 In the figure, each side of the thalamus - cortex has median length 130.64 mm and 123.14 mm respectively The similarity is also seen in the average length of the thalamus – cortex, with 130.17 mm on the right compared to that of the left side at 121.21 mm, and the difference is statistically significant with p < 0.05 Table 3.21 Compare the average length of the thalamocortical tracts by gender on both sides Gender The average length of the ± SD p thalamocortical tracts Left 118,94 ± 13,70 0,012 Female Right 127,85 ± 9,37 Average 123,39 ± 12,45 Left 123,32 ± 13,22 0,016 Male Right 132,32 ± 12,88 Average 127,82 ± 13,70 13 Comment: Table 3.21 shows the average length of the thalamocortical tracts between left and right in females is 118,94 mm and 127,85 mm respectively The female's average length of the thalamocortical tracts on the right is longer than the left, a statistically significant result with (p < 0,05) The male’s average length of the thalamocortical tracts on the left is 123,32 mm and the right is132,32 mm; which mean the average length of the thalamocortical tracts on the right is longer than the left - a statistically significant result with (p < 0,05) 3.3.1.2 The morphological characteristics about the number of thalamocortical tracts’s fibers Table 3.23 The number of fibers's the left and right thalamocortical tracts (fibers) Giới tính The number of Media n p fibers n Left 347,0 24 0,773 Male Right 398,5 24 Average 366,5 48 Left 295,5 26 0,405 Female Right 401,5 26 Average 355,5 52 Left 315,00 50 0,549 Both Right 401,50 50 (Two genders) Average 365,50 100 Comment: Table 3.23 shows median value about the number of fibers of thalamocortical tracts’s female in the left is 347,0 and the right is 398,5 The median value about the number of fibers of thalamocortical tracts’s female between the left and the right is not statistically significant with p > 0.05 the number of fibers of thalamocortical tracts’s male in the left is 295,5 fibers and in the right is 401,5 fibers The number of fibers of 14 the thalamocortical tracts in the left is lower than the right which is not statistically significant with p > 0.05 Median value about the number of fibers of thalamocortical tracts in the left is 315 fibers, in the right is 401,5 fibers; The number of fibers of the thalamocortical tracts in the right is higher than the left but the difference is not statistically significant, with p > 0,05 Table 3.24 Compare the average length of the thalamocortical tractson the right and the left in gender (fibers) Male Female Average (n = 26) (n = 24) (n = 50) The thalamocortical tracts p Median Median Median value value value Number of fibers on the left 295,50 347,00 315,00 0,396 Number of fibers on the right 401,50 398,50 401,50 0,777 Comment: Table 3,24’s result shows the number of fibers on the right side is almost the same for both gender, while the number of male's fibers on the left side is lower than female but the difference is not statistically significant, with p > 0,05 3.3.2 Morphological forms of the thalamocortical tracts Table 3.30 Statistics of the number and distribution of branching morphologies of the thalamocortical tracts group Morphological Left Right Total forms n % n % n % branches (2) (3) (5) branches 11 (11) 14 (14) 25 (25) branches 20 (20) 22 (22) 42 (42) branches 10 (10) (6) 16 (16) branches (7) (5) 12 (12) Opposite branches (50) (50) 100 (100) 15 Comment: Table 3.30 results show that the thalamocortical tracts’ branches are polymorphism In which, the group of branches accounts for 42%, the group of branches accounts for 25%, the group of branches accounts for 16%, the group of branches accounts for 12% and the least group of branches accounts for 5% From the image we can see shows that there are branches with equal proportions on the right and left, each accounting for 50% 3.3.3 Characteristics of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the thalamocortical tracts 3.3.3.1 Characteristics of fractional anisotropy (FA) of the thalamocortical tracts Table 3.32 Compare the average value of the FA between the left and the right FA Gender n ± SD p Male 26 0,483 ± 0,022 Left 0,235 Female 24 0,474 ± 0,026 Male 26 0,482 ± 0,022 Right 0,659 Female 24 0,479 ± 0,025 Left General 50 0,479 ± 0,024 0.716 (2 sides) Right 50 0,480 ± 0,023 General (2 sides) 100 0,479 ± 0,023 Comment: Table 3.32 and Figure 3.6 show the mean FA value between left and right, we see these value are equal with no difference between left and right with p> 0.05 Mean FA values between left and right for men and women were similar and there was no difference between left and right with p> 0.05 3.3.3.2 Characteristics of apparent diffusion coefficient (ADC) of the thalamocortical tracts 16 Table 3.34 Compare the mean ADC value between left and right (10-3mm2 / sec) FA Gender n ± SD p Male 26 0.830 ± 0.051 Left 0,805 Female 24 0.827 ± 0.060 Male 26 0.826 ± 0.044 Right 0,130 Female 24 0.806 ± 0.045 Left 50 0,829 ± 0,055 0,236 General Right 50 0,816 ± 0,045 General (2 sides) 100 0,823 ± 0,050 Comment: Table 3.34 and Figure 3.7 show that mean ADC values between left and right for both men and women have no differences between left and right with p> 0.05 Mean ADC values between left and right for men and women had no difference between left and right with p> 0.05 CHAPTER IV DISCUSSIONS 4.1 Age and gender characteristics of research subjects Our research sample has 26 males, accounting for 52%, and 24 females, accounting for 48% The male / female ratio is approximately 1.08, all of the participants are adults and they spread across all groups from young to middle-aged and old age Compared with the world, studies on the structure of the thalamus, the number of subjects participating in our research is limited, lower than in the study of author Fikret S et al (2005) performed on 161 normal Turks (100 males, 61 females), or author Mohammad RM (2008) studied 97 healthy Iranians (44 males, 53 females) 17 A study with a similar sample size with our study is the study of structures under the cortex (thalamus included) on MRI images conducted by Wang XY et al (2016) performed on 53 healthy Han Chinese Study subjects were also divided into groups: 30 young people (15 females); 12 middle-aged people (6 females) and 11 elderly people (4 females) 4.2 Morphological characteristics of the thalamus 4.2.1 Characteristics of the size and volume of the thalamus Characteristics of the length of the thalamus Regardless of gender, in our study, the mean length of the left (31.12 mm) and the right (31.23 mm) thalamus with (p = 0.756> 0.05) Similar to our results, the study of Brierley JB et al (1959) on 53 cerebral hemispheres from 47 bodies showed that the thalamus length does not distinguish right and left within the limit (31-38 mm), average value 34.5 mm The study by Mohammadi et al resulted in mean lengths of the left (33.40 ± 1.65 mm) and right (33.39 ± 1.51 mm) thalamus Rayyan Tutunji's study on 12 18-year-olds showed the average length of the thalamus: 33.20 mm, there was no statistically significant difference between the right, left, or between men and women Width characteristics of the thalamus - Regardless of gender, in our study, the width of the thalamus on both sides is similar: left (16.46 mm) and right (16.46 mm) with (p = 0.979) Research results of Muhammad et al Width of the left thalamus (22.11 ± 1.12 mm) and right (22.00 ± 1.14 mm) In an autopsy study, Van Buren and Maccubbin, (1962) performed an autopsy on 16 patients (aged to 78) with no neuropathy and showed that the upper thalamus width was within 12.5 to 21 mm Rayyan Tutunji's study on 12 18-yearolds showed the average width of the thalamus: 21.55 mm Height characteristics of the thalamus 18 Our research results show that all three dimensions, length, width, and height of the left and right thalamus are lower than the results of published world publications, possibly due to the subject Our research is that Vietnamese people have a smaller figure than the author's research subjects such as Mohammadi is indigenous Fars in northern Iran and Fikres SEN's research subject is Turkish States Morphological characteristics of the volume of the thalamus In this study, we also compare the thalamus volume between the two hemispheres, the results showed that the right is larger than the left, this result is similar to some previous studies However, in Damle and Ahsan's study the opposite results are found: the volume of the left thalamus is greater than the right The difference between studies may be related to either the age of the subjects because there is a relationship between the age and the thalamus’s volume of two hemispheres or depending on research methods The change in volume with age may be related to the decrease and degeneration of neurons or the synapses between nerve cells But so far, the neurological mechanism of asymmetry in the two hemispheres has not been determined 4.3 Characteristics of the thalamocortical tracts 4.3.1 Length characteristics of the thalamocortical tracts When measuring fiber thalamus-cortex's dimension, our results show that the average length on both sides is 125.69 mm The average length of the right thalamocortical tracts (130.17 mm) is longer than the left (121.21 mm), the difference between the two is statistically significant with p 0.05 A comparison of the length of the fiber thalamocortical tracts between the two genders shows that the male tends to be longer than that in women, this may be due to the fact that the male brain is larger than that of the female, but the difference is not statistically significant possibly because the number of analyzes is not large enough 4.3.3 The number of fibers of the thalamocortical tracts Theoretically, the number of talamocortical tracts is proportional to the number of nerve cells in the central cortex to which they are connected People with more axons, they will have more cells in the central regions of the thalamocortical tracts and vice versa The results of statistical analysis show that the median number of fibers of the left thalamocortical tracts is 315 fibers and the right is 401.5 fibers, it showed count of fiber of the thalamocortical tracts This result is somewhat contrary to the conclusion of Alkonyi B, when considering the common white matter in the two hemispheres, the author concludes that the left thalamus has a significantly higher overall cortical connection than the right thalamus This can be hypothesized that since the majority of study subjects are right-handed, the transmittance may also be different between the right and the left In 20 order to clarify this subject, we need to have a large-scale study with enough study objects 4.3.6 Forms of the thalamocortical tract The results in our study show thalamocortical fibers branching polymorphic In particular, the group of branches is topped the list (42%), followed by the group of branches with 25%, the group of branches and the group of branches account for 16% and 12% respectively and the group of branches reaches the lowest rank, with 5% The image obtained shows that there are branchings on the right and left sides equivalent to each side accounting for 50% However, there is no difference between the right and the left in the number of branching forms Therefore, the distribution to the cerebral cortex of the thalamocortical tract is more abundant than that of the corticospinal tract in some studies such as Seo JP and his associates research on 36 healthy adults, found corticospinal tracts originated from the primary motor cortex (36.9%), from the motor sensory cortex (31.7%), from the secondary motor cortex (24%) and from the dorsal motor cortex (6.7%) 4.3.7 Characteristics of the fractional anisotropy (FA) and apparent diffusion coefficient maps (ADC) of the thalamocortical tract 4.3.7.1 Characteristics of the fractional anisotropy (FA) of the thalamocortical tract When comparing the average FA value between the left and the right, we found that there is no difference between the left and the right with p > 0.05 The research comparing the FA values of the thalamocortical tract between healthy people and people with cerebral palsy, Shoko Y and his partner concluded that the FA index of the thalamocortical tract in children with cerebral palsy was significantly lower than in healthy children in the comparison group However, in the study of Thomas and 21 his associate, the decrease in the FA index in patients with cerebral palsy has not been confirmed 4.3.7.2 Characteristics of apparent diffusion coefficient (ADC) of the thalamocortical tracts Apparent Diffusion Coefficient (ADC) measures the diffusion amplitude of water molecules in the nerve organization, when the value of ADC is low, it means that the pathways in the white matter are tightly organized, intact, and ADC value is high when the pathway loses its normal structure, the pathway is damaged In our study, the mean ADC values between the left and the right were (0.829 ± 0.055) 10-3 mm2 / sec and (0.816 ± 0.045) 10-3 mm2 / sec, respectively This value has no difference between left and right side with p > 0.05 Morita et al's study on 19 patients with brain tumor (16 men, women, aged 39 to 70), including 12 patients with normal motor function and patients with abnormal motor function were assessed by myotonus, pathological reflexes: Hoffmann, Babinski, The results showed that the ADC index of the thalamocortical tracts of patients with abnormal movements increased compared to patients with normal motor functions with p < 0.01 CONCLUSION Through research on 50 subjects using diffusion tensor imaging (DTI), we draw the following conclusions: Morphology of the thalamus in a normal adult on tesla magnetic resonance image has the following characteristics: - The average thalamus length of + Both genders on the left side are 31.12 mm and the right side is 31.23 mm; + In Female on the left is 30.92 mm and on the right is 31.05 mm; 22 + In Male on the left is 31.30 mm and the one on the right is 31.38 mm - Average thalamus width of + Both genders on the left side are 16.46 mm and the right side is 16.46 mm; + Female on the left side is 16.14 mm and on the right side is 16.16 mm; + Male on the left side is 16.76 mm and the one on the right is 16.74 mm - Average thalamus height of + Both genders on the left side are 16.77 mm and the right side is 16.79 mm; + Female on the left side is 16.67 mm and on the right side is 16.70 mm; + Male on the left side is 16.87 mm and on the right side is 16.88 mm - The average thalamus volume of + Both genders on the left side are 6.42 ml and the right side is 6.43 ml; + Female on the left is 6.18 ml and on the right is 6.19 ml; + Male on the left is 6.65 ml and on the right is 6.65 ml Morphology of the tractus thalamocortical tracts in normal adults on the 3.0 tesla diffusion tensor image has the following characteristics: - The median length value of the thalamocortical tracts of the both genders on the left is 123.14 mm and on the right is 130.64 mm - Average length of thalamocortical tracts + Both genders on the left side are 121.21 mm and the right side are 130.17 mm; 23 + Male on the left side is 123.32 mm and on the right is 132.32 mm; + Female on the left is 118.94 mm and on the right is 127.85 mm - The median value of the number of the thalamocortical tracts + Both genders on the left side are 315 fibers and on the right side are 401.5 fibers; + Male on the left is 295.5 fibers and on the right is 401.5 fibers; + Female on the left side is 347.0 fibers and on the right side is 398.5 fibers - Branched morphological types of the thalamocortical tracts are diverse: branches account for 5%, branches account for 25%, branches account for 42%, branches account for 16% and branches account for 12% - Average value of fractional anisotropy (FA) of the thalamocortical tracts: + Both genders on the left are 0.480 and the right side are 0.479; + In male on the left is 0.482 and the right is 0.483; + In female on the left is 0.474 and on the right is 0.479 - Average value of apparent diffusion coefficient of the thalamocortical tracts: + Both genders on the left are 0.829 and the right side are 0.816; + Male on the left is 0.830 and on the right is 0.826; Fgender + Female on the left is 0.827 and on the right is 0.806 24 RECOMENDATION Our study has initially determined the morphological characteristics of the thalamocortical tracts of normal Vietnamese adult on diffusion tensor (DTI) image However, the study has some limitations: The number of sample size is small, so it is difficult to isolate and exclude some objective factors affecting the study To solve this problem, we recommend to continue to expand the sample size with a larger number, add more functional exploration method of the nervous system, study some other related pathways such as motor pathway, cortico-cerebellar parthway, Frontal–Occipital pathway, temporal - occipital pathway etc for more objective and comprehensive results ARTICLES PUBLISHED THE RESULTS OF THE THESIS Phạm Thành Nguyên, Lâm Khánh, Nguyễn Duy Bắc (2017), “Nghiên cứu đặc điểm hình thái đồi thị người trưởng thành bình thường cộng hưởng từ khuếch tán 3.0 Tesla, Tạp chí Y – Dược học Quân sự, số chuyên đề tháng 9/2017, pp 64-72 Pham Thanh Nguyen, Lam Khanh, Nguyen Duy Bac (2018), “Anatomical characteriristics of thalamus – cortical sensory tract in the human brain using diffusion tensor tractography at 3.0 Tesla scanner”, Journal of military pharmaco-medicine, pp 129-136 ... THE RESULTS OF THE THESIS Phạm Thành Nguyên, Lâm Khánh, Nguyễn Duy Bắc (2017), ? ?Nghiên cứu đặc điểm hình thái đồi thị người trưởng thành bình thường cộng hưởng từ khuếch tán 3.0 Tesla, Tạp chí... not been studied in Vietnam The objectives of the study are to: Describe the morphological features of the thalamus on the 3.0 tesla magnetic resonance image in healthy Vietnamese adults Determine... in ordinary Vietnamese adults These are valuable scientific data of morphological characteristics of the thalamus and the thalamocortical tracts on MRI 3.0 images in normal Vietnamese adults This
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