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As an important pre-processing step in clinical applications, automatic and accurate 3D cardiovascular image segmentation has attracted more and more attention. However, cardiovascular structures are often with high diversity, blood pool and myocardium shapes are also with large variability, and ambiguous cardiac borders make the segmentation task very challenging. In this paper, a novel deep neural network to segment the blood pool and myocardium from three dimensional cardiovascular images is introduced by fully exploiting the global context and complementary information encoded in different feature extraction layers, referred to as GCEFG-R<sup>2</sup>Net briefly. In order to semantically locate the two kinds of regions in a global manner, we design a global context pooling module which can effectively learn context information in a global manner from the deep features extracted from the last two deep layers. Instead of directly using or combining different levels of deep features, we develop an interactive feature aggregation strategy to enhance different levels of deep features by embedding a series of interactive feature aggregation modules. By using the enhanced features, a residual feature refining branch is designed for refining the side outputs in a top-down stream with the guidance of global context features. Finally, the refined side outputs of different layers and the enhanced deep features are combined to generate the final segmentation result by using a feature fusion module. Extensive experiments on two challenge datasets are conducted to demonstrate that the proposed GCEFG-R<sup>2</sup>Net can obtain appealing segmentation results for the blood pool and myocardium and performs better than other state-of-the-art methods.

Global Context and Enhanced Feature Guided Residual Refinement Network for 3D Cardiovascular Image Segmentation