Fig. 34

Tram track sign. The tram track sign may be explained by the presence of thickened bronchial branches on radiographs (black arrowheads in a and b), which reproduce a “tram line” appearance clearly shown on c. In d, the same appearance could be also described in a CT of a patient with cystic fibrosis: the coronal CT image shows thickened bronchial branches (cylindrical bronchiectasis)