I am not entirely sure what your workflow is but I assume you are exporting a model from Fusion 360 as a high res .stl , which obviously results in a dense triangulated mesh. You might wan to change the relatively large aspect ratio to something smaller for better sculpting results in ZBrush.
Th next assumption is that you apply the high fidelity detail to that triangulated mesh in ZBrush using the sculpting tools. This will likely result in an even higher resolution triangulated mesh.
So far so good. The usual workflow s to then re-mesh that dense triangulated mesh to arrive at a lower poly count quad mesh that is still retaining all the sculpted features.
Once you have a quad mesh as a .obj you can try to import that into Fusion 360 ( turn off auto triangulation in the preferences). That mesh you might be able to convert into a T-Spline. Whether that works is really a question of how the surface is structures and how many quad polygons you have in the mesh.
If it does work, the T-Spline will accurately reflect the re-meshed detail you sculpted in ZBrush, with the difference that it now can be converted into a BRep and then precision machined.
Converting it to a BRep directly from a mesh willingly work if you reduce the mesh loosing all the finely crafted sculpted details. then of course the BRep will also not be smooth, but faceted. For low end 3D prints that might be OK but unlike;y for a precision machined mold.
If the quad polygon count is too high for Fusion 360 there are at least a couple of other non AD software options available, albeit at a higher price.
Cyborg 3D makes a Sub-D quad mesh converter that comes standalone or also as a direct t plugin for MoDo. It is the same engine the powers the Power Surfacing in Solid Works.
Solid Thinking Evolve has poly nurbs and in my tests abut a year ago importing and converting a complex quad mesh into a NURBS surface was 17 times faster than a T-Splines conversion in Fusion 360. But is is definitely not a cheap option!