Department of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.
Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
PLoS One. 2019 Jan 10;14(1):e0210334. doi: 10.1371/journal.pone.0210334. eCollection 2019.
A thrombolysis in cerebral infarction (TICI) score of 2b is defined as a good recanalization result although the reperfusion may only cover 50% of the affected territory. An additional mTICI2c category was introduced to further differentiate between mTICI scores. Despite the new mTICI2c category, mTICI2b still covers a range of 50-90% reperfusion which might be too imprecise to predict neurological improvement after therapy.
To compare the 7-point "expanded TICI" (eTICI) scale with the traditional mTICI in regard to predict functional independence at 90 days.
Retrospective review of 225 patients with large artery occlusion. Angiograms were graded by 2 readers according the 7-point eTICI score (0% = eTICI0; reduced clot = eTICI1; 1-49% = eTICI2a, 50-66% = eTICI2b50; 67-89% = eTICI2b67, 90-99% = eTICI2c and complete reperfusion = eTICI3) and the conventional mTICI score. The ability of e- and mTICI to predict favorable outcome at 90days was compared.
Given the ROC analysis eTICI was the better predictor of favorable outcome (p-value 0.047). Additionally, eTICI scores 2b50, 2b67 and 2c (former mTICI2b) were significantly superior at predicting the probability of a favorable outcome at 90 days after endovascular therapy with a p-value of 0.033 (probabilities of 17% for mTICI2b50, 24% for mTICI2b67 and 54% for mTICI2c vs. 36% for mTICI2b).
The 7-point eTICI allows for a more accurate outcome prediction compared to the mTICI score because it refines the broad range of former mTICI2b results.
尽管再通仅覆盖病变区域的 50%，但 TICI 评分 2b 仍被定义为良好的再通效果。为了进一步区分 mTICI 评分，引入了额外的 mTICI2c 类别。尽管有了新的 mTICI2c 类别，但 mTICI2b 仍然涵盖了 50-90%的再通范围，这可能过于不精确，无法预测治疗后的神经功能改善。
比较 7 分“扩展 TICI”（eTICI）评分与传统 mTICI 在预测 90 天功能独立性方面的差异。
回顾性分析 225 例大动脉闭塞患者。两位读者根据 7 分 eTICI 评分（0%=eTICI0；血栓减少=eTICI1；1-49%=eTICI2a，50-66%=eTICI2b50；67-89%=eTICI2b67，90-99%=eTICI2c，完全再通=eTICI3）和传统 mTICI 评分对血管造影进行分级。比较 eTICI 和 mTICI 预测 90 天预后的能力。
根据 ROC 分析，eTICI 是预测良好预后的更好指标（p 值 0.047）。此外，eTICI 评分 2b50、2b67 和 2c（原 mTICI2b）在预测血管内治疗后 90 天良好预后的概率方面明显优于 mTICI2b（mTICI2b50 的概率为 17%，mTICI2b67 的概率为 24%，mTICI2c 的概率为 54%，mTICI2b 的概率为 36%），p 值均<0.05。
与 mTICI 评分相比，7 分 eTICI 允许更准确的预后预测，因为它细化了原 mTICI2b 结果的广泛范围。
