Diffusion Plug-in Priors for Self-Supervised Ultrasound Video Restoration

Ultrasound imaging is widely used for real-time, noninvasive diagnosis, but speckle and related artifacts reduce image quality and can hinder interpretation. We present a diffusion-based ultrasound despeckling method built on the Image Restoration Stochastic Differential Equations framework. To enable supervised training, we curate large paired datasets by simulating ultrasound images from speckle-free magnetic resonance images using the Matlab UltraSound Toolbox. The proposed model reconstructs speckle-suppressed images while preserving anatomically meaningful edges and contrast. On a held-out simulated test set, our approach consistently outperforms classical filters and recent learning-based despeckling baselines. We quantify prediction uncertainty via cross-model variance and show that higher uncertainty correlates with higher reconstruction error, providing a practical indicator of difficult or failure-prone regions. Finally, we evaluate sensitivity to simulation probe settings and observe domain shift, motivating diversified training and adaptation for robust clinical deployment.

Ultrasound B-mode imaging commonly suffers from speckle noise and artifacts, requiring a delicate balance between contrast, resolution, and preservation of anatomical structures. Although recently developed despeckling methods have achieved some progress, supervised learning approaches remain fundamentally limited by the ground truth paradox, which arises from the absence of noise-free, ground truth reference images in in vivo scenarios. Existing unsupervised diffusion-based methods typically enforce data consistency directly in the nonlinear log-compressed domain, which can disproportionately amplify background artifacts when mapped back to the envelope domain. To overcome these limitations, we propose an uncertainty-guided null-space diffusion (UGNS) framework, a novel label-free solution that enforces consistency correction on a stabilized positive-envelope proxy obtained via inverse log compression. The proposed UGNS introduces several technical novelties: (a) extraction of a structural prior in the stabilized envelope domain to produce a robust signal envelope that preserves anatomical structure, (b) development of an adaptive range-null reconstruction mechanism that uses an adaptive weight mask to preserve tissue regions via range-space projection, and (c) introduction of uncertainty-guided fusion in an adaptive way to mitigate sampling variability. Extensive and comparative experiments were conducted using the PICMUS benchmark and in vivo datasets. The results demonstrate that UGNS achieves competitive generalized contrast-to-noise ratio (gCNR) values across diverse datasets. In addition, it is successfully validated that UGNS effectively suppresses speckle noise while preserving fine spatial resolution. Code is available at https://github.com/yousirong/UGNS.git.

Medical ultrasound (US) is inherently degraded by speckle, a granular interference pattern that is often treated as a complex form of noise in image restoration. However, unlike random noise, US speckle originates from coherent scattering within tissue and is therefore highly spatially dependent and deterministic under fixed acquisition conditions, making US speckle suppression fundamentally different from natural image denoising. Because speckle-free US targets are unavailable in practice, self-supervised denoising is necessary. Blind-spot networks (BSN) are the dominant self-supervised paradigm for natural images, but their pixel-wise masking strategy assumes spatially independent noise, an assumption poorly matched to US speckle, which is spatially correlated over multiple pixels rather than pixel-wise independent. To address this mismatch, we propose Mask2Restore, a self-supervised US despeckling framework that reformulates despeckling as contextual inpainting with block-wise masking on single noisy images. Unlike pixel-wise BSN masking, block-wise masking addresses this multi-pixel speckle correlation by removing locally correlated speckle neighborhoods and shifting the reconstruction cues used by the network from adjacent speckle correlations to broader anatomical context. We further introduce cross-resolution context regularization (CRCR), which suppresses residual speckle bias by enforcing consistency across multi-resolution predictions. Experiments on simulated and in vivo carotid US, unseen fine-structure cases, and downstream cardiac segmentation demonstrate improved speckle-detail trade-offs, better preservation of fine anatomical structures, and practical value for subsequent image analysis.