The specific texture on B-scan images is believed to be related to both ultrasound machine characteristics and tissue properties, i.e., the pathological states of the soft tissue. Therefore, for classification, features can be extracted with the use of image texture analysis techniques. In this paper a novel fuzzy approach for texture characterization is used for classification of normal liver and diffused liver diseases, here fatty liver, liver cirrhosis, and hepatitis are emphasized. The texture analysis techniques are diversified by the existence of several approaches. We propose fuzzy features for the analysis of the texture image. For this, a membership function is constructed to represent the effect of the neighboring pixels on the current pixel in a window. Using these membership function values, we find a feature by weighted average method for the current pixel. This is repeated for all pixels in the window treating each time one pixel as the current pixel. Using these fuzzy based features, we derive three descriptors: maximum, entropy, and energy as used in co-occurrence method, for each window.
Endoscopic ultrasound (EUS)-guided injection therapy is the new frontier in the management of patients with hepatobiliary disease. Celiac plexus block/neurolysis was the first form of injection therapy and has been validated in many subsequent trials. Cyst ablation therapy, fiducial insertion, angiography, portal hypertensive therapy, endoscopic portosystemic shunt creation, portal vein embolization and injection of chemotherapeutic/biologic agents for antitumor therapy are more recent uses and will be discussed. Celiac plexus neurolysis is currently well established in providing adjunct pain control in patients with advanced malignancy. There are limited data available for its use in benign conditions. EUS-guided ablative therapy for pancreatic cysts remains an area for future research but seems to have a role for small thin-walled non-septated cysts. EUS-guided implantation of fiducials is technically feasible but its exact impact on tumor regression is unknown. Several case reports have documented EUS-guided alcohol and thrombin injection into pseudoaneurysms and cyanoacrylate and coil embolization for variceal therapy. Injection of viral vectors and immunomodulating cell cultures as antitumor therapy has been described but the evidence is still preliminary and further data are awaited.
Primary tumours of the liver are uncommon in childhood. Of these, more than two-thirds are malignant. As such, benign hepatic tumours are often not considered in the differential diagnosis of a hepatic mass in childhood. We report a case of hepatic mesenchymal hamartoma, a rare benign tumour, in a 10-month-old infant. This tumour is characterised by an admixture of ductal structures within a copious loose connective tissue stroma. Only approximately 160 cases had been reported in the literature. Awareness of the ultrasound (U/S) and computed tomography (CT) features, although not diagnostic, is helpful in distinguishing it from the more common malignant tumours. A correct preoperative diagnosis is important as surgical excision is often curative.