Qi Zhou ¹ Yingwen Zhou ^1* Nailong Hou ^1* Yaxuan Zhang ^1* Guanyu Zhu ^1* liang Li ^2*

• ¹ School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
• ² Department of Radiotherapy, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

In bronchial ultrasound elastography, accurately segmenting mediastinal lymph nodes is of great significance for diagnosing whether lung cancer has metastasized. However, due to the ill-defined margin of ultrasound images and the complexity of lymph node structure, accurate segmentation of fine contours is still challenging. Therefore, we propose a dual-stream feature-fusion attention U-Net (DFA-UNet). Firstly, a dual-stream encoder (DSE) is designed by combining ConvNext with a lightweight vision transformer (ViT) to extract the local information and global information of images; Secondly, we propose a hybrid attention module (HAM) at the bottleneck, which incorporates spatial and channel attention to optimize the features transmission process by optimizing high-dimensional features at the bottom of the network. Finally, the feature-enhanced residual decoder (FRD) is developed to improve the fusion of features obtained from the encoder and decoder, ensuring a more comprehensive integration. Extensive experiments on the ultrasound elasticity image dataset show the superiority of our DFA-UNet over 9 state-of-the-art image segmentation models. Additionally, visual analysis, ablation studies, and generalization assessments highlight the significant enhancement effects of DFA-UNet. Comprehensive experiments confirm the excellent segmentation effectiveness of the DFA-UNet combined attention mechanism for ultrasound images, underscoring its important significance for future research on medical images.