Background: Accurate volumetric assessment of spontaneous subarachnoid hemorrhage (SAH) is a labor-intensive task performed with current manual and semiautomatic methods that might be relevant for its clinical and prognostic implications. In the present research, we sought to develop and validate an artificial intelligence-driven, fully automated blood segmentation tool for SAH patients via noncontrast computed tomography (NCCT) scans employing a transformer-based Swin UNETR architecture. Methods: We retrospectively analyzed NCCT scans from patients with confirmed aneurysmal subarachnoid hemorrhage (aSAH) utilizing the Swin UNETR for segmentation. The performance of the proposed method was evaluated against manually segmented ground truth data using metrics such as Dice score, intersection over union (IoU), the volumetric similarity index (VSI), the symmetric average surface distance (SASD), and sensitivity and specificity. A validation cohort from an external institution was included to test the generalizability of the model. Results: The model demonstrated high accuracy with robust performance metrics across the internal and external validation cohorts. Notably, it achieved high Dice coefficient (0.873), IoU (0.810), VSI (0.840), sensitivity (0.821) and specificity (0.996) values and a low SASD (1.866), suggesting proficiency in segmenting blood in SAH patients. The model's efficiency was reflected in its processing speed, indicating potential for real-time applications. Conclusions: Our Swin UNETR-based model offers significant advances in the automated segmentation of blood after aSAH on NCCT images. Despite the computational intensity, the model operates effectively on standard hardware with a user-friendly interface, facilitating broader clinical adoption. Further validation across diverse datasets is warranted to confirm its clinical reliability.

利用Swin UNETR的基于人工智能的完全自动化血液分割工具，该研究开发和验证了针对非对比增强CT（NCCT）扫描的SAH患者的自发性蛛网膜下腔出血（SAH）的准确容积评估方法，其效果鲁棒且具有广泛的临床可采用性。

A Fully Automated Pipeline Using Swin Transformers for Deep
  Learning-Based Blood Segmentation on Head CT Scans After Aneurysmal
  Subarachnoid Hemorrhage

基于Swin Transformers的全自动流水线用于脑动脉瘤硬膜下出血后头部CT扫描的基于深度学习的血液分割