Structure-Aware Deep Learning for Pediatric Echocardiographic Standard-View Classification in Ultrasonic Imaging.

Accurate standard-view classification is essential for pediatric echocardiographic image analysis and downstream automated interpretation. This task remains challenging because discriminative view information is often encoded in subtle chamber configurations, outflow-tract morphology, and weak anatomical boundaries, whereas conventional classifiers may underuse shallow and intermediate representations that preserve spatial structure. We propose PVTv2-ASEF, a structure-aware framework for 4-class pediatric echocardiographic standard-view classification. The framework introduces an Adaptive Structural Enhancement Module that performs residual input-side conditioning through channel recalibration, local convolutional mixing, multi-scale structural modeling, and input-dependent branch weighting. It further employs a Dual Auxiliary Fusion Head to transform Stage 2 and Stage 3 representations into class-level evidence and fuse them with the final-stage logits during inference. PVTv2-ASEF was evaluated on a private pediatric ventricular septal defect echocardiography dataset comprising 4 standard views under repeated patient-disjoint evaluation, with macro-F1 used as the primary class-balanced metric. Compared with PVTv2-B2, the proposed framework improved macro-F1 by 0.093 on the private dataset and by 0.023 in cross-task evaluation on FETAL_PLANES_DB. These results support the utility of coordinated input-side structural enhancement and intermediate logit fusion for ultrasound view and plane classification.