The application of fractal analysis to parametric imaging of B-mode echograms and to differentiation of echographic speckle textures was investigated. Echograms were obtained from realistic simulations and from a clinical study on diffuse liver disease. The simulations comprised tissue models with randomly positioned scatterers in a 3-D volume in which the number density was varied over a range from 0.5 to 25 mm-3. The clinical echograms comprised both normals and patients with liver cirrhosis. Three methods of estimating the fractal dimension were investigated, two in the spatial image domain and one in the spatial frequency domain. The results of these methods are compared and the applicability and the limitations of texture differentiation using fractal analysis is discussed. The main conclusion is that fractal analysis offers no obvious advantage over statistical analysis of the texture of echographic images. Its use for parametric imaging is further limited by the need to use relatively large windows for local estimation of the fractal dimension.