目的　探讨成人股骨头缺血坏死的早期CT表现和新征象。方法　回顾性阅读具有典型X线和CT表现并经病理或随访证实的 12 7例成人股骨头缺血坏死的CT片 ,分析其征象及变化。结果　CT表现 :股骨头完整组有 90个关节 ,其中单纯高密度硬化 6 7个股骨头 ,伴低密度区者 2 3个股骨头。股骨头塌陷组 111个髋关节 ,其中 2 5个股骨头示单纯高密度硬化 ,86个伴低密度区。 43个股骨头内出现气体。随访病例中 ,股骨头外形和密度也表现出一定规律。结论　股骨头内单纯高密度硬化是本病的早期征象 ,其特殊的形态组合有重要诊断价值。股骨头内气体也是该病的征象 Objective To investigate the early CT manifestations and new signs of adult avascular necrosis of femoral head. Methods The CT images of 12 7 adult avascular necrosis of femoral head patients with typical X-ray and CT findings and confirmed by pathology or follow-up were retrospectively reviewed. Their signs and changes were analyzed. Results CT showed that there were 90 joints in the intact femoral head group, including 67 cases of high density sclerosis and 23 cases of femoral head accompanied by low density. In the femoral head collapse group, there were 111 hips, of which 25 had simple high-density sclerosis and 86 had low-density areas. Gas appeared in 43 femoral heads. Follow-up cases, the shape and density of the femoral head also showed some laws. Conclusions Hypertrophic sclerosis in the femoral head is an early sign of this disease, and its special morphological combination has important diagnostic value. Femoral head gas is also a sign of the disease