EchoVim: Making Vision Mamba Docile for Echocardiography Video Segmentation via Dynamic Interaction and Semantic Token-attentive Refinement

Automatic echocardiography video segmentation is a powerful tool for improving the accuracy of cardiovascular function assessment. However, it remains a challenging task owing to (1) extensive speckle noise and blurred boundaries, (2) dramatic shape variations of targeting structures across frames, and (3) limited labeled data due to the high cost of annotation. In this paper, we present a novel semi-supervised segmentation model based on Vision Mamba (Vim) to comprehensively tackle these challenges; we call it EchoVim. Our framework introduces three technical innovations: First, a bidirectional inference mechanism (BIM) which can propagate label information bidirectionally from end-diastolic (ED) and end-systolic (ES) frames to generate pseudo-labels, coupled with confidence-aware dynamic updating to progressively refine supervision signals. Second, a dynamic interaction temporal alignment (DITA) module that establishes anatomical correspondence across frames by adaptively enhancing features near temporally stable regions while suppressing motion-irrelevant artifacts, effectively addressing variations in cardiac shape. Third, a semantic token-attentive refinement (STR) module that constructs low-rank semantic tokens to encode cardiac structure priors, utilizing attention-guided nonlinear transformations to disentangle speckle noise from true anatomical patterns. We conduct extensive experiments on two benchmarking echocardiography video datasets: CAMUS and EchoNet-Dynamic, and the results demonstrate that our method outperforms existing state-of-the-art approaches with real-time inference. Codes are available at https://github.com/guojx2255/EchoVim.