目的探讨上矢状窦血栓形成动脉溶栓的疗效及影响预后因素。方法对19例上矢状窦血栓形成的患者行MRI和MRA检查。提升平均动脉压15%并减低脑血管阻力;动脉溶栓治疗并观察疗效。结果19例中9例急性发病型在MRI上表现为静脉灌流区域斑状短T1、长T2高信号影。10例慢性发病型的患者MRI显示静脉灌流区域脑水肿性改变,溶栓治疗后预后良好(与急性发病型比较P<0.05)。结论早期MRI及MRA检查对上矢状窦血栓形成诊断有重要意义;提升脑灌注压与动脉溶栓治疗是本病的有效治疗方法;发病在24h以内的急性型病例及上矢状窦后1/3闭塞的病例预后较差。 Objective To investigate the curative effect of upper thoracic sinus thrombosis arterial thrombolysis and prognostic factors. Methods MRI and MRA were performed in 19 patients with upper sagittal sinus thrombosis. Increase mean arterial pressure by 15% and reduce cerebral vascular resistance; arterial thrombolysis and observe the effect. Results Nine of the nineteen acute-onset cases showed MRI-like short-twitching T1 and long-T2 hyperintensity on MRI. MRI findings of 10 patients with chronic disease showed cerebral edema in the area of ​​venous perfusion. The prognosis was good after thrombolysis (P <0.05 compared with acute onset type). Conclusion Early MRI and MRA examination of the superior sagittal sinus thrombosis diagnosis is important; enhance cerebral perfusion pressure and arterial thrombolysis is an effective treatment of this disease; the incidence of acute cases within 24 hours and the superior sagittal sinus after 1 / 3 occlusion of the poor prognosis.