UniFLM: United Segmentation and Measurement on Fetal Limb Ultrasonic Image

Prenatal ultrasound examination is crucial for assessing fetal limb development and detecting congenital anomalies. However, existing artificial intelligence models often overlook fetal lethal skeletal dysplasias due to the lack of high-quality annotated data and a unified framework for multiple long bones. Moreover, generic segmentation models struggle with the inherent noise and semantic gaps in ultrasound images. To address these challenges, we construct the Fetal Limb Bones (FLB) dataset, comprising high-quality annotations for the humerus, femur, tibia-fibula, and radius-ulna. Furthermore, we propose UniFLM (United Segmentation and Measurement on Fetal Limb Ultrasonic Image), a unified framework for automatic cross-plane segmentation and measurement. UniFLM incorporates a Semantic Alignment Skip Connection (SASC) module to bridge the semantic gap between encoder and decoder features, and a Positive Sampling (PoSamp) strategy to filter noise and extract essential semantic information. Finally, a Point Regression Mapping (PRM) module is introduced to learn clinician annotation patterns for precise bone length measurement. Extensive experiments conducted on the FLB dataset and the public FetalP5 benchmark demonstrate that UniFLM achieves competitive performance with consistent generalization across four bone categories and external multi-center data, supported by comprehensive statistical validation including Bland-Altman agreement analysis and bootstrap confidence intervals. The source code is publicly available at https://github.com/chosen1203/UniFLM.