Objective  To explore the application value of multimodal imaging reconstruction technology in the diagnosis and treatment of sacral cysts.

Methods  This study included 50 patients with sacral cysts who were treated surgically between June 2023 and December 2023 at the Department of Neurosurgery, Beijing Friendship Hospital, Capital Medical University. These patients consisted of 11 males and 39 females, with an average age of (46.5±12.4) years. Prior to operation, multimodal imaging technologies, such as CT, MRI (3D-CISS sequence), and 3D Slicer, were used to accurately classify the patients depending on whether their sacral canal cyst contains nerve roots as follows: nerve and nonnerve root type cysts. The accuracy of these classifications was verified intraoperatively. The statistical method used was Fisher′s exact probability method.

Results Among the patients, 36(72.0%) had nerve root cysts, 14(28.0%) had nonnerve root cysts, and 5(10.0%) showed presacral cysts. Among the 14 patients with nonnerve root cysts, 21 cysts with an average volume of (20.66±9.46) cm³ were found. Among the 36 patients with nerve root cysts, 94 cysts (average of 2.61±2.06 cysts per patient) were recorded. Among these nerve root cysts, 71(75.5%) involved the nerve root, affecting 80 nerve roots. Averages of 2.22±1.59 nerve roots involved per patient and 0.86±0.23 nerve roots involved per cyst were recorded. The accuracy of nerve root assessment for sacral cysts using multimodal imaging technology (98.0%, 45/50) was significantly higher than that using traditional imaging technology (70.0%, 35/50) (Fisher's exact probability method, P<0.001).

Conclusions Multimodal imaging reconstruction technology based on 3D Slicer can achieve the precise classification and preoperative evaluation of sacral cysts, substantially improving diagnostic accuracy and providing reliable basis for individualized surgical planning.