Segmenting anatomical structures and lesions from ultrasound images contributes to disease assessment. Weakly supervised learning (WSL) based on sparse annotation has achieved encouraging performance and demonstrated the potential to reduce annotation costs. This study attempts to introduce scribble-based WSL into ultrasound image segmentation tasks. However, ultrasound images often suffer from poor contrast and unclear edges, coupled with insufficient supervison signals for edges, posing challenges to edge prediction. Uncertainty modeling has been proven to facilitate models in dealing with these issues. Nevertheless, existing uncertainty estimation paradigms are not robust enough and often filter out predictions near decision boundaries, resulting in unstable edge predictions. Therefore, we propose leveraging predictions near decision boundaries effectively. Specifically, we introduce Dempster-Shafer Theory (DST) of evidence to design an Evidence-Guided Consistency strategy. This strategy utilizes high-evidence predictions, which are more likely to occur near high-density regions, to guide the optimization of low-evidence predictions that may appear near decision boundaries. Furthermore, the diverse sizes and locations of lesions in ultrasound images pose a challenge for CNNs with local receptive fields, as they struggle to model global information. Therefore, we introduce Visual Mamba based on structured state space sequence models, which achieves long-range dependency with linear computational complexity, and we construct a novel hybrid CNN-Mamba framework. During training, the collaboration between the CNN branch and the Mamba branch in the proposed framework draws inspiration from each other based on the EGC strategy. Experiments demonstrate the competitiveness of the proposed method. Dataset and code will be available on https://github.com/GtLinyer/MambaEviScrib.
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