Objective To evaluate the application value of X-ray fluoroscopy-based 3D visualization in cerebrovascular anatomy learning for clinical medical students. Methods Undergraduate students majoring in clinical medicine from the West China School of Medicine, Sichuan University, were enrolled between June and August 2025. Using a random number table method, the enrolled students were divided into an experimental group and a control group. From cerebrovascular angiography images, two images with a 3° separation angle were selected and synthesized into left-right 3D images for the experimental group, while identical images were merged into left-right planar images for the control group. After standardized classroom instruction, the experimental group viewed the 3D images, while the control group observed the planar images. The two groups were compared regarding their evaluations of image quality, image-reading time, and accuracy in identifying cerebrovascular lesions. Results A total of 42 students were included, with 21 in each group. There were no statistically significant differences in age or gender between the two groups (P>0.05). The total image-reading time in the experimental group was significantly shorter than that in the control group [(279.95±66.14) vs. (407.24±149.67) s, P=0.001], and the lesion identification accuracy was higher in the experimental group [(0.96±0.06)% vs. (0.88±0.14)%, P=0.022]. Moreover, subjective evaluations regarding image stereopsis and perceived difficulty in lesion identification were significantly better in the experimental group (P＜0.001). Conclusions The application of X-ray fluoroscopy-based 3D visualization significantly improves the learning outcomes of cerebrovascular diseases among clinical medical students.
