Objective To evaluate the diagnostic efficacy of the radiological features of pancreatic CT imaging in patients with functional abdominal pain (FAP), recurrent acute pancreatitis (RAP), and chronic pancreatitis (CP).

Methods Retrospective analysis was performed on the CT image data of 168 patients who received abdominal enhanced CT examination in Beijing Tiantan Hospital, Capital Medical University from December 2017 to December 2020. According to the criteria for admission and emission, 48 patients were selected for the study, including 23 males and 25 females, aged 39 to 84 (47.8±10.2) years, and 16 cases of FAP (FAP group), 18 cases of RAP (RAP group), and 14 cases of CP (CP group). The pancreas outline was obtained by drawing the region of interest on the CT image. Sixty-two radiologic features were extracted from each region of interest, which were divided into five categories, namely, the first-order statistics, the gray-level co-occurrence matrix (GLCM), the gray-level run-length matrix, the neighbouring gray tone difference matrix (NGTDM), and the morphological features, and compared among the three groups. According to the groups, three IsoSVM machine learning models were established, trained, and tested on the missing cross validation samples. The Wilcoxon rank sum test was used to compare the radiation characteristics of the patients with RAP, FAP, and CP. The predictive performance of individual radiological characteristics was evaluated using the receiver operator characteristic curve and the area under the curve (AUC).

Results In the univariate analysis, a significant difference was found between the patient groups in nine radiation group characteristics (eight GLCM characteristics and one NGTDM characteristic) (Z=3.45–29.76, all P<0.05). Compared RAP patients with FAP and CP patients, the AUC ranges were 0.76–0.93 and 0.73–0.91. The overall prediction accuracy of the IsoSVM machine learning model was 82.1%. The sensitivity and specificity of the FAP group were 78.7% and 100%, respectively, and the AUC was 0.90. The sensitivity and specificity of the RAP group were 95.2% and 77.8%, respectively, and the AUC was 0.87, while those of the CP group were 70.9%, 94.8%, and 0.89, respectively.

Conclusion Some of the radiographic features of CT imaging have a good evaluation efficiency in the diagnosis of pancreatitis and can distinguish between patients with FAP, RAP, and CP.