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MSA Hot Cross Bun sign

Last updated on Saturday, May 30 2009 by jdmiles

MSA Hot Cross Bun sign

The hot cross bun sign is seen in the pons on T2-weighted or FLAIR imaging in patients with MSA-c. It occurs because myelinated transverse pontocerebellar fibers and neurons in the pontine raphe are selectively lost in this disease, while the corticospinal tracts and tegmentum are preserved. As shown in this T2 MRI, it looks like a big white plus sign in the pons.

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MSA Hot Cross Bun sign with arrow

MSA Hot Cross Bun sign with arrow
The unnecessarily large green arrow points to the middle of the white the cross in the pons in this T2 MRI image of a patient with MSA.

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