Microcirculatory Obstruction Segmentation by Using Regional Prior Constraints and Adaptive Bias Correction

Mingfeng Jiang1, zimin Zou1, Jucheng Zhang2, Dongdong Deng3, wenlong xu4, Ling Xia5
1Zhejiang Sci-Tech University, 2The Second Affiliated Hospital Zhejiang University School of Medicine, 3Dalian University of Technology, 4China Jiliang University, 5Zhejiang University


Abstract

Microvascular obstruction (MVO) is an important imaging biomarker associated with adverse prognosis following reperfusion therapy in acute myocardial infarction. In late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images, MVO typically appears as small hypo-intense regions embedded within scar tissue. Owing to its small size, ill-defined boundaries, and severe class imbalance, accurate and robust automatic segmentation of MVO remains challenging for existing deep learning methods. To address these challenges, this study proposes a hierarchical segmentation framework based on regional prior constraints and adaptive bias correction. Firstly, a three-stage cascaded segmentation model is constructed to progressively segment the myocardial ring, scar region, and MVO, where anatomical spatial priors are incorporated to gradually constrain the search space. Secondly, a bias-aware mechanism is introduced to identify difficult pixels, and cross-sample similar pixel replacement is employed to achieve adaptive enhancement of hard regions, thereby alleviating model bias during training. In addition, a structurally constrained loss function based on contour distance distribution modeling is proposed to improve spatial consistency from a global shape perspective. Based on the public EMIDEC dataset, extensive experimental results demonstrate that the proposed method achieves significant improvements over several state-of-the-art approaches in terms of Dice coefficient and 95% Hausdorff distance (HD95), validating its effectiveness and robustness for MVO segmentation.