TRUST: Efficient Abdominal Trauma Recognition via Image-to-Ultrasound-Video Transfer Learning

Enguang Wang, Hao Zhou, Shuo Gao, Tuo Liu, Guangquan Zhou

Abdominal ultrasound is indispensable for rapid, noninvasive trauma triage. However, interpreting the subtle dynamic cues embedded in continuous scanning is time-intensive and operator-dependent. Parameter-Efficient Image-to-Video Transfer Learning (PEIVTL), which efficiently adapts pre-trained image models to the video domain, notably through visual-textual alignment, offers a promising paradigm for ultrasound video analysis. Nevertheless, substantial spatiotemporal and semantic variations arising from physician-dependent scanning practices continue to limit the effectiveness and generalizability of this framework. We propose TRUST, a scan-aware PEIVTL framework that explicitly models fine-grained spatiotemporal variations to enable reliable ultrasound video understanding. First, we introduce a Cross-Frequency Collaborative Adapter (CFCA) that establishes mutual constraints between low- and high-frequency components, enhancing discriminative spatial feature extraction under heavy speckle corruption. Second, we design a Multi-Granularity Motion-Aware (MGMA) module that integrates local temporal convolutions with motion-prior-guided global self-attention, jointly capturing stable intra-view patterns and abrupt inter-view transitions to characterize complex scanning dynamics. Third, a Visual Query Semantic Aggregation (VQSA) module dynamically generates text prototypes conditioned on visual features, enabling adaptive visual-textual alignment robust to intra-class variability under diverse scanning conditions. Experiments on in-house ultrasound trauma datasets demonstrate that TRUST outperforms state-of-the-art methods by 9.63% with superior computational efficiency.