Medical image segmentation serves as a critical technique in clinical applications such as disease diagnosis, surgical planning, and image-guided therapy, where segmentation accuracy directly impacts the precision of clinical decisions. However, existing methods still face significant challenges in handling inherent issues of medical images, including blurred boundaries, complex multi-scale structures, and difficulties in fine-grained feature representation. To address these challenges, this paper proposes a medical image segmentation method based on a diffusion probabilistic model, MFDiff, which aims to enhance multi-scale contextual awareness and fine-grained structural modeling capabilities. The method incorporates a frequency-aware attention fusion module that effectively strengthens the model’s ability to represent complex structures and ambiguous boundaries. Additionally, a multi-scale feature enhancement module is introduced to expand the receptive field while maintaining low computational cost, thereby improving the extraction and fusion of multi-scale features. Furthermore, an uncertainty-weighted majority voting fusion strategy is proposed to enhance the robustness and consistency of fused predictions from multiple sampling iterations. The proposed method was validated on five medical image segmentation datasets. Experimental results demonstrate that MFDiff outperforms current mainstream methods across all datasets, exhibiting strong generalization ability and robustness.
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