Medical image segmentation is crucial for clinical diagnosis and treatment planning, especially when dealing with complex anatomical structures such as vessels. However, accurately segmenting vessels remains challenging due to their small size, intricate edge structures, and susceptibility to artifacts and imaging noise. In this work, we propose VesselSAM, an enhanced version of the Segment Anything Model (SAM), specifically tailored for aortic vessel segmentation. VesselSAM incorporates AtrousLoRA, a novel module integrating Atrous Attention and Low-Rank Adaptation (LoRA), to enhance segmentation performance. Atrous Attention enables the model to capture multi-scale contextual information, preserving both fine-grained local details and broader global context. Additionally, LoRA facilitates efficient fine-tuning of the frozen SAM image encoder, reducing the number of trainable parameters and thereby enhancing computational efficiency. We evaluate VesselSAM using two challenging datasets: the Aortic Vessel Tree (AVT) dataset and the Type-B Aortic Dissection (TBAD) dataset. VesselSAM achieves state-of-the-art performance, attaining DSC scores of 93.50\%, 93.25\%, 93.02\%, and 93.26\% across multi-center datasets. Our results demonstrate that VesselSAM delivers high segmentation accuracy while significantly reducing computational overhead compared to existing large-scale models. This development paves the way for enhanced AI-based aortic vessel segmentation in clinical environments. The code and models will be released at https://github.com/Adnan-CAS/AtrousLora.
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