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Citation:
Sharma R, Bagel sign (Behçet disease). Reference article, Radiopaedia.org (Accessed on 13 Jan 2025) https://doi.org/10.53347/rID-183942
The bagel sign is a radiological sign appreciated on MRI spine that is described in patients with neuro-Behçet disease-associated myelitis.
The sign describes the involvement of the spinal cord as seen on axial T2 sequences in patients with myelitis, whereby there is a round hyperintense lesion with a hypointense central core 1-4. There may or may not be peripheral post-gadolinium enhancement, and the ring may or may not be complete 1-4. Overall, this gives the appearance to that of a bagel 1-4. On sagittal sequences, lesions with the bagel sign often demonstrate features of a longitudinally extensive transverse myelitis 1.
In one study of patients with neuro-Behçet disease and myelitis, the bagel sign was present in 93% of cases 1. The bagel sign has not been described in other inflammatory myelopathies 1.
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1. Uygunoglu U, Zeydan B, Ozguler Y et al. Myelopathy in Behçet's Disease: The Bagel Sign. Ann Neurol. 2017;82(2):288-98. doi:10.1002/ana.25004 - Pubmed
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2. Cacciaguerra L, Sechi E, Rocca M, Filippi M, Pittock S, Flanagan E. Neuroimaging Features in Inflammatory Myelopathies: A Review. Front Neurol. 2022;13:993645. doi:10.3389/fneur.2022.993645 - Pubmed
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3. Uygunoglu U & Siva A. An Uncommon Disease Included Commonly in the Differential Diagnosis of Neurological Diseases: Neuro-Behçet's Syndrome. J Neurol Sci. 2021;426:117436. doi:10.1016/j.jns.2021.117436 - Pubmed
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4. Yazdi B & Abdi S. Bagel Sign in Neuro Behçet's Disease Myelitis: Neuroimages. Neurol Sci. 2023;44(8):2987-8. doi:10.1007/s10072-023-06815-8 - Pubmed
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