The Role of Computed Tomography and Magnetic Resonance Imaging in the Evaluation of Congenital Brain Malformations: An Observational Study from a Tertiary Care Hospital

Objective: To evaluate the diagnostic utility of CT and MRI in detecting and characterizing congenital brain malformations (CBMs), to facilitate classification and parental counselling. Materials and Methods: In this prospective observational study, 82 pediatric patients (<18 years) with suspected congenital brain anomalies underwent CT, MRI, or both. Imaging findings were categorized by etiology and compared across modalities. Results: CBMs were identified in 61 patients. MRI alone detected anomalies in 37 of 50 cases (74%), while CT alone revealed anomalies in 8 of 12 (66%). Combined imaging identified abnormalities in 16 of 20 cases (80%). Cortical malformations (45.9%) were the most common, followed by phakomatoses and posterior fossa anomalies. A strong association with consanguinity (40.9%) and familial history (16.2%) was observed. Conclusion: MRI remains the imaging modality of choice for CBMs due to its superior soft tissue contrast and multiplanar capabilities, while CT provides complementary value in skeletal and cranial vault assessment. Accurate imaging is critical for prognosis, therapy, and genetic counselling.