{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T20:35:13Z","timestamp":1781555713883,"version":"3.54.5"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82473472"],"award-info":[{"award-number":["82473472"]}]},{"name":"National Natural Science Foundation of China","award":["SJC2021022"],"award-info":[{"award-number":["SJC2021022"]}]},{"name":"Suzhou Basic Research Pilot Project","award":["82473472"],"award-info":[{"award-number":["82473472"]}]},{"name":"Suzhou Basic Research Pilot Project","award":["SJC2021022"],"award-info":[{"award-number":["SJC2021022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Accurate segmentation of brain vessels is critical for diagnosing cerebral stroke, yet existing AI-based methods struggle with challenges such as small vessel segmentation and class imbalance. To address this, our study proposes a novel 2D segmentation method based on the nnUNet framework, enhanced with MedSAM\/MedSAM2 features, for arterial vessel segmentation in time-of-flight magnetic resonance angiography (TOF-MRA) brain slices. The approach first constructs a baseline segmentation network using nnUNet, then incorporates MedSAM\/MedSAM2\u2019s feature extraction module to enhance feature representation. Additionally, focal loss is introduced to address class imbalance. Experimental results on the CAS2023 dataset demonstrate that the MedSAM2-enhanced model achieves a 0.72% relative improvement in Dice coefficient and reduces HD95 (mm) and ASD (mm) from 48.20 mm to 46.30 mm and from 5.33 mm to 4.97 mm, respectively, compared to the baseline nnUNet, showing significant enhancements in boundary localization and segmentation accuracy. This approach addresses the critical challenge of small vessel segmentation in TOF-MRA, with the potential to improve cerebrovascular disease diagnosis in clinical practice.<\/jats:p>","DOI":"10.3390\/jimaging11060202","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T09:36:00Z","timestamp":1750239360000},"page":"202","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MedSAM\/MedSAM2 Feature Fusion: Enhancing nnUNet for 2D TOF-MRA Brain Vessel Segmentation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0080-0205","authenticated-orcid":false,"given":"Han","family":"Zhong","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China"},{"name":"Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215613, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0257-8932","authenticated-orcid":false,"given":"Jiatian","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China"},{"name":"Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215613, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1952-3026","authenticated-orcid":false,"given":"Lingxiao","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China"},{"name":"Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215613, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1474-4422(24)00369-7","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990\u20132021: A systematic analysis for the Global Burden of Disease Study 2021","volume":"23","author":"Feigin","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1016\/j.immuni.2024.07.002","article-title":"Brain ischemia causes systemic Notch1 activity in endothelial cells to drive atherosclerosis","volume":"57","author":"Liu","year":"2024","journal-title":"Immunity"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s12975-022-01023-6","article-title":"Optical coherence tomography in cerebrovascular disease: Open up new horizons","volume":"14","author":"Xu","year":"2023","journal-title":"Transl. 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