NEUROIMAGING / NEUROSONOLOGY
Thrombolysis in Brain Ischemia (TIBI)
David Goldemund M.D.
Updated on 20/09/2023, published on 14/02/2023
Updated on 20/09/2023, published on 14/02/2023
- the TIBI classification was developed to grade residual flow
- it correlates with initial stroke severity, clinical recovery, and mortality in acute stroke patients
- no improvement in the residual flow correlates with the absence of early clinical recovery and increased mortality (Demchuk, 2012)
- no improvement in the residual flow correlates with the absence of early clinical recovery and increased mortality (Demchuk, 2012)
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TIBI 0 – absent flow
– lack of regular pulsatile flow signals despite varying degrees of background noise
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TIBI 1 – minimal flow
– systolic spikes of variable velocity and duration
– EDV = 0
– possible reverberating flow
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TIBI 2 – blunted flow
– flattened systolic flow acceleration of variable duration compared to control side
– PI < 1,2 – positive EDV |
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TIBI 3 – dampened flow
– normal systolic flow acceleration
– positive EDV – decreased flow (MFV) by > 30% compared to the control (healthy) side
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TIBI 4 – stenotic flow
– MFV > 80cm/s + velocity difference (MFV) of > 30% compared to the control side (increased velocity)
– turbulence + velocity difference (MFV) of > 30% compared to the control side (increased velocity) |
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TIBI 5 – normal flow – symmetrical flow or < 30% MFV difference compared to the control side |
According to [Demchuk, 2001]
| Recanalization assessment [Clotbust, 2007] |
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| Complete recanalization | TIBI 4-5 |
| Parcial recanalization | increase of TIBI by ≥1 grade (but not to 4 or 5) |
| Reocclusion | decrease of TIBI by ≤1 grade |
