Topics

Topic

design image
Superior lingular artery of left lung

The superior lingular artery is a segmental branch of the left pulmonary artery, supplying the superior segment (S4) of the lingula in the left upper lobe. The left pulmonary artery gives rise to the upper lobe branches, which include the lingular trunk. This trunk typically divides into the superior lingular artery (A4) and the inferior lingular artery (A5), supplying the two lingular bronchopulmonary segments.

Anatomically, the superior lingular artery runs anteroinferiorly along the course of the superior lingular bronchus (B4), accompanied by segmental veins and bronchi within the segmental unit. The lingular arteries are homologous to the middle lobe arteries of the right lung, reflecting embryological symmetry.

Clinically, the superior lingular artery is important in segmentectomy, lobectomy, and pulmonary embolism detection. Its variations are significant in thoracic surgery and interventional radiology, where precise mapping of segmental vasculature is essential.

Synonyms

  • A4 branch of left pulmonary artery

  • Left superior lingular segment artery

  • Segment IV artery (left lung)

Function

  • Supplies oxygenated blood to the superior lingular segment (S4) of the left lung

  • Contributes to perfusion of the left upper lobe

  • Functions as part of the pulmonary arterial tree, ensuring gas exchange

  • Acts as a key surgical landmark in segmental resections

Branches

  • Intrapulmonary segmental branches that follow B4 bronchus

  • Anastomotic connections with adjacent pulmonary arterial branches

MRI Appearance
T1-weighted images:

  • Appears as a tubular flow void (black lumen) within the lingular parenchyma

  • Surrounding pulmonary tissue and fat provide contrast

T2-weighted images (normal):

  • Flow void maintained; lumen dark against high-signal lung background

  • Pathology (e.g., thrombus) may alter intraluminal signal intensity

T2 TRUFISP (cardiac/respiratory-gated):

  • Demonstrates superior lingular artery as a bright, continuous lumen with sharp definition

  • Provides cine-like assessment of arterial course and patency

STIR:

  • Fat suppression enhances visualization of vessel margins within mediastinal and hilar fat

  • Perivascular edema or inflammation appears hyperintense

T1 Post-Contrast (Gadolinium-enhanced MRI):

  • Artery enhances homogeneously and brightly

  • Filling defects indicate embolus or stenosis

  • Useful for detailed pulmonary arterial mapping

MRI Non-Contrast Cardiac-Gated 3D Imaging:

  • Depicts the course of the superior lingular artery (A4) from the left pulmonary artery to its segmental distribution

  • Provides non-contrast anatomical mapping for patients with contrast contraindications

  • Important for surgical planning and congenital anomaly assessment

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA highlights the lingular trunk and its division into A4 and A5

  • Useful for detecting stenosis, occlusion, or anomalous branching

CT Appearance
CT Coronary Angiography (CCTA) / Pulmonary CT Angiography (CTA):

  • Superior lingular artery visualized as a contrast-filled segmental branch of the left pulmonary artery

  • Multiplanar and 3D reconstructions show its origin, course, and relation to the lingular bronchus

  • Gold standard for detecting pulmonary embolism, anatomical variants, and surgical planning

  • Differentiates vascular structures from hilar lymphadenopathy or masses

CT image

Superior lingular artery of left lung anatomy CT axial image -img-00000-00000

MRI image

Superior lingular artery of left lung MRI AXIAL IMAGE