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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