Background: Cerebellopontine angle lesions represent a significant proportion of intracranial tumors, with schwannomas comprising the majority. Magnetic resonance imaging has revolutionized the diagnostic approach to these lesions with its superior soft tissue contrast resolution and multiplanar capabilities.

Objective: To evaluate the role of magnetic resonance imaging in localizing and characterizing cerebellopontine angle schwannomas and to compare findings with surgical and histopathological outcomes.

Methods: A prospective observational study was conducted over five months involving 20 patients presenting with clinical features suggestive of cerebellopontine angle lesions. All patients underwent magnetic resonance imaging using a 1.5 Tesla Phillips scanner with standard protocol including T1-weighted, T2-weighted, diffusion-weighted imaging, and fluid-attenuated inversion recovery sequences in axial, sagittal, and coronal planes. Gadopentate dimeglumine was administered as contrast agent where indicated. Imaging findings were correlated with surgical and histopathological results.

Results: The study population consisted predominantly of patients aged 21-40 years, with female preponderance. Vestibular schwannomas constituted 95% of cases, with vestibulocochlear nerve involvement in 85% of patients. On T1-weighted images, 95% of schwannomas were hypointense relative to brain parenchyma, while all cases demonstrated hyperintense signal on fluid-attenuated inversion recovery sequences without restricted diffusion. Post-contrast imaging revealed marked to moderate enhancement in all schwannomas. Magnetic resonance imaging demonstrated 100% sensitivity, 92.86% specificity, 94.12% positive predictive value, and 96.67% overall accuracy in diagnosing vestibular schwannomas when correlated with histopathology.