用注意力机制分割脑白质病变,区分血管性和脱髓鞘病因。
Attention-Based Segmentation of WMHs and Differentiation of Vascular vs. Demyelinating Lesions

- 结合注意力模块与形态特征分类,提升病变定位与病因判断准确率。
- 在5个数据集上验证,模型对两类病变的区分效果优于传统方法。
- 适合神经影像分析、临床辅助诊断研究者参考使用。
脑白质高信号(WMHs)常见于脑部磁共振成像(MRI),与血管性及炎症性脱髓鞘疾病相关。尽管病因不同,这两类病变在液体抑制反转恢复(FLAIR)图像上常呈现相似形态,导致鉴别诊断困难。本文提出将注意力机制驱动的分割与基于形态特征的分类相结合的方法,以更精准高效地区分血管性与脱髓鞘性白质病变。针对分割任务,评估了瓶颈注意力模块(BAM)与卷积块注意力模块(CBAM)的有效性,并测试了Attention U-Net等网络结构。同时采用基于图像块的训练策略和2.5D输入方式提升病灶检测能力。分割后提取病变掩膜的形态学特征,用于病因分类。实验基于五个公开数据集,涵盖多样成像协议,以增强模型泛化能力,尽管样本量有限。结果表明,该方法为区分两类白质病变提供了有前景的方向,但仍需在更大临床队列中进一步验证。
原文摘要 · Abstract (English)
White Matter Hyperintensities (WMHs) are commonly observed in brain Magnetic Resonance Imaging (MRI) scans. They are associated with various neurological conditions, including vascular and inflammatory demyelinating diseases. Despite differing in etiology, WMHs from these conditions often appear similar on Fluid Attenuated Inversion Recovery (FLAIR) images. This similarity makes differential diagnosis challenging. In this work, we highlight the potential of combining attention-based segmentation with feature-driven classification. This approach supports more accurate and efficient classification between vascular and demyelinating white matter pathologies. For segmentation, we evaluate the effectiveness of attention mechanisms, specifically the Bottleneck Attention Module (BAM) and the Convolutional Block Attention Module (CBAM). We also test different architectures, particularly Attention U-Net. In addition, we explore advanced training strategies, such as patch-based learning and a 2.5D approach, to enhance lesion detection. After segmentation, we extract morphological features from the lesion masks. We then use them to classify WMHs based on their underlying cause. Our experiments utilize five publicly available datasets with diverse imaging protocols to promote model generalizability, despite limited sample sizes. The results suggest that attention-based segmentation and feature-driven classification offer a promising direction for discriminating vascular and demyelinating white matter lesions. Further validation in larger clinical cohorts is still needed.
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