Fig. 16

Neuroradiological imaging findings. Different severity degrees of brain atrophy seen in three MPS patients. Axial (a) and coronal (d) T2-weighted fast spin-echo brain images of a 2-year-old male with MPS II show almost normal subarachnoid and ventricular spaces. The T2-weighted acquisitions (b and e) in a second MPS patient (a 45-year-old female affected by Morquio disease) reveal mild enlargement of subarachnoid spaces. Brain images (c and f) in a third MPS patient (an 18-year-old female affected by MPS VI) demonstrate higher enlargement of subarachnoid spaces, with associated dilatation of ventricles. Patients with MPS IV and VI typically have normal intelligence and don’t show signs of atrophy until the second decade of life; on the contrary, brain atrophy usually develops earlier in MPS I, II, III and VII, becoming visible during the first few years of life