CTICasesDouble Artery Sign
Imaging findings
High-resolution CT chest in an oncology patient shows a small, solid-appearing nodule in the right upper lobe immediately adjacent to a branch of the pulmonary artery. Reconstruction on thin 1-mm sections demonstrates that the 'nodule' represents a branching tubular structure filled with soft-tissue density material, running parallel to the adjacent pulmonary artery, representing an airway impacted with mucus.
Key takeaways
The 'double artery sign' is a CT sign of mucoid impaction in a small airway. Under normal circumstances, a pulmonary artery branch is accompanied by an air-filled bronchus of similar caliber. If the airway becomes impacted with mucus, it appears as a solid tubular structure running parallel to the artery, mimicking two side-by-side vessels. Recognizing this prevents mistaking mucus plugs for pulmonary metastases.
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