Zhigao Zeng, Jiale Xiao, Shengqiu Yi, Qiang Liu, Yanhui Zhu
Medical image segmentation presents substantial challenges arising from the diverse scales and morphological complexities of target anatomical structures. Although existing Transformer-based models excel at capturing global dependencies, they encounter critical bottlenecks in multi-scale feature representation, spatial relationship modeling, and cross-layer feature fusion. To address these limitations, we propose the M3-TransUNet architecture, which incorporates three key innovations: (1) MSGA (Multi-Scale Gate Attention) and MSSA (Multi-Scale Selective Attention) modules to enhance multi-scale feature representation; (2) ME-MSA (Manhattan Enhanced Multi-Head Self-Attention) to integrate spatial priors into self-attention computations, thereby overcoming spatial modeling deficiencies; and (3) MKGAG (Multi-kernel Gated Attention Gate) to optimize skip connections by precisely filtering noise and preserving boundary details. Extensive experiments on public datasets—including Synapse, CVC-ClinicDB, and ISIC—demonstrate that M3-TransUNet achieves state-of-the-art performance. Specifically, on the Synapse dataset, our model outperforms recent TransUNet variants such as J-CAPA, improving the average DSC to 82.79% (compared to 82.29%) and significantly reducing the average HD95 from 19.74 mm to 10.21 mm.