The advent of deep-learning-based registration networks has addressed the time-consuming challenge in traditional iterative methods.However, the potential of current registration networks for comprehensively capturing spatial relationships has not been fully explored, leading to inadequate performance in large-deformation image registration.The pure convolutional neural networks (CNNs) neglect feature enhancement, while current Transformer-based networks are susceptible to information redundancy.To alleviate these issues, we propose a pyramid attention network (PAN) for deformable medical image registration.Specifically, the proposed PAN incorporates a dual-stream pyramid encoder with channel-wise attention to boost the feature representation.Moreover, a multi-head local attention Transformer is introduced as decoder to analyze motion patterns and generate deformation fields.Extensive experiments on two public brain magnetic resonance imaging (MRI) datasets and one abdominal MRI dataset demonstrate that our method achieves favorable registration performance, while outperforming several CNN-based and Transformer-based registration networks.Our code is publicly available at https://github.com/JuliusWang-7/PAN.

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