Epicardial adipose tissue (EAT) is a type of visceral fat that can secrete large amounts of adipokines to affect the myocardium and coronary arteries. EAT volume and density can be used as independent risk markers measurement of volume by noninvasive magnetic resonance images is the best method of assessing EAT. However, segmenting EAT is challenging due to the low contrast between EAT and pericardial effusion and the presence of motion artifacts. we propose a novel feature latent space multilevel supervision network (SPDNet) with uncertainty-driven and adversarial calibration learning to enhance segmentation for more accurate EAT volume estimation. The network first addresses the blurring of EAT edges due to the medical images in the open medical environments with low quality or out-of-distribution by modeling the uncertainty as a Gaussian distribution in the feature latent space, which using its Bayesian estimation as a regularization constraint to optimize SwinUNETR. Second, an adversarial training strategy is introduced to calibrate the segmentation feature map and consider the multi-scale feature differences between the uncertainty-guided predictive segmentation and the ground truth segmentation, synthesizing the multi-scale adversarial loss directly improves the ability to discriminate the similarity between organizations. Experiments on both the cardiac public MRI dataset (ACDC) and the real-world clinical cohort EAT dataset show that the proposed network outperforms mainstream models, validating that uncertainty-driven and adversarial calibration learning can be used to provide additional information for modeling multi-scale ambiguities.

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