Optimized left atrial appendage segmentation via hierarchical cross-scale consistency with gated routing for echocardiography

Accurate left atrial appendage (LAA) delineation is vital for atrial fibrillation-related left atrial appendage occlusion (LAAO) planning and device sizing; yet transthoracic echocardiography (TTE) segmentation is challenged by speckle noise, acoustic shadowing, low or variable contrast, pronounced anatomical variability, and limited annotated data. We propose a lightweight, plug-in module, the Hierarchical Cross-Scale Consistency with Gated Routing (H-CSCA), which preserves the U-Net topolog...