Application Value of Multimodal Imaging Three-Dimensional Fusion in Surgery for Central Region Tumors: A Retrospective Controlled Study

Abstract Objective To investigate the clinical value of preoperative multimodal imaging three-dimensional (3D) fusion reconstruction in microsurgical treatment of tumors involving the central region, and to evaluate its impact on the extent of resection, intraoperative venous preservation, and postoperative complications. Methods A total of 50 patients with central region tumors who underwent microsurgical treatment in the Department of Neurosurgery, Hubei No. 3 People's Hospital of Jianghan University, from February 2021 to February 2025 were retrospectively enrolled. Based on whether preoperative multimodal imaging 3D fusion was employed to assist surgical planning, patients were divided into the 3D fusion group (n = 25) and the conventional imaging group (n = 25). In the 3D fusion group, 3D reconstruction was performed based on multimodal imaging data to formulate individualized surgical approaches and venous protection strategies. In the conventional imaging group, surgical plans were determined solely by routine imaging interpretation. General baseline characteristics, operative time, intraoperative blood loss, extent of resection, critical superficial venous injury, postoperative complications, and Karnofsky Performance Status (KPS) score at discharge were compared between the two groups. Results No significant differences were observed between the two groups in sex, age, pathological type, lesion laterality, maximum tumor diameter, or preoperative peritumoral edema grade (all P > 0.05). The gross total resection (GTR) rate was significantly higher in the 3D fusion group than in the conventional imaging group [88.0% (22/25) vs. 64.0% (16/25), P < 0.05]. Operative time and intraoperative blood loss were significantly lower in the 3D fusion group [(182.6 ± 34.8) min vs. (214.3 ± 39.7) min; (226.0 ± 82.5) mL vs. (308.0 ± 96.4) mL; both P < 0.01]. The incidence of critical superficial venous injury was significantly lower in the 3D fusion group [8.0% (2/25) vs. 32.0% (8/25), P < 0.05]. The 3D fusion group demonstrated lower rates of postoperative cerebral edema exacerbation, new-onset or worsened neurological deficits, and overall complications compared with the conventional imaging group, while KPS at discharge was significantly higher (all P < 0.05). The agreement rates between preoperative 3D fusion reconstruction and intraoperative findings regarding superficial venous morphological configuration, predominant venous course, and tumor–vein spatial relationship were 96.0%, 92.0%, and 100.0%, with Kappa values of 0.948, 0.881, and 1.000, respectively. Conclusion Multimodal imaging 3D fusion reconstruction can accurately delineate the spatial relationships between central region tumors and the superficial venous system, thereby facilitating optimization of surgical strategies, improving the extent of resection, and reducing critical venous injury and postoperative complications. This technique demonstrates substantial clinical application value in surgery for central region tumors.