To assess the clinical value of multimodality fusion and three-dimensional (3D) reconstruction technology in surgical treatment of eloquent area lesions.

Thirty-one patients with functional area lesions who underwent surgical treatment at the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from May 2021 to June 2022 were selected as the research subjects. 3D slicer software was used to perform 3D reconstruction and fusion processing on preoperative enhanced MRI, diffusion tensor imaging (DTI), MRI or CT vascular imaging results. The relative relationship between the lesion and the nearby skull, cerebral sulcus, nerve conduction bundle, and blood vessels was visualized, and the optimal surgical plan was designed based on the principle of maximum safe resection. Follow up MRI after surgery and assess the degree of tumor resection based on intraoperative conditions. The Karnofsky performance status (KPS) and Boston diagnostic aphasia examination (BDAE) were used to evaluate the neurological function status.

The imaging data of all patients can clearly display the specific location of the lesion through multimodal fusion and 3D-reconstruction technology, including 19 cases involving the sensorimotor area and 13 cases involving the linguistic function. The maximum diameter of the tumor is 22.0-90.1 mm. A total of 26 patients underwent gross total resection, while subtotal resection in 4 cases and partial resection in one case. Pathological results showed glioma (WHO grade 2-4) in 21 cases, metastatic tumor in 2 cases, meningioma in 5 cases, lymphoma in 1 case, Rosai Dorfman disease in 1 case, and echinococcosis in 1 case. Postoperative improvement of neurological function was found in 23 cases, while no changes in 5 cases and deteriorations in 3 cases. The changes of KPS score and BDAE grading before and after surgery were statistically significant (P<0.05).

Based on 3D-slicer software for image post-processing and 3D-reconstruction visualization, the relationship between brain functional area lesions and corresponding brain surface morphology can be clearly displayed, which helps to evaluate the extent of lesions and invasion of peripheral nerve conduction bundles, thereby achieving maximum resection of lesions while preserving important nerve function.