title: Spectral waveform analysis of intranodal arterial blood flow in abnormally large superficial lymph nodes in dogs.
abstract: OBJECTIVE
  To evaluate pulsed-wave Doppler spectral parameters as a method for distinguishing between neoplastic and inflammatory peripheral lymphadenopathy in dogs.
  
  
  METHODS
  40 superficial lymph nodes from 33 dogs with peripheral lymphadenopathy.
  
  
  METHODS
  3 Doppler spectral tracings were recorded from each node. Spectral Doppler analysis including assessment of the resistive index, peak systolic velocity-to-end diastolic velocity (S:D) ratio, diastolic notch velocity-to-peak systolic velocity (N:S) ratio, and end diastolic velocity-to-diastolic notch velocity ratio was performed for each tracing. Several calculation methods were used to determine the Doppler indices for each lymph node. After the ultrasonographic examination, fine needle aspirates or excisional biopsy specimens of the examined lymph nodes were obtained, and lymphadenopathy was classified as either inflammatory or neoplastic (lymphomatous or metastatic) via cytologic or histologic examination. Results of Doppler analysis were compared with cytologic or histopathologic findings.
  
  
  RESULTS
  The Doppler index with the highest diagnostic accuracy was the S:D ratio calculated from the first recorded tracing; a cutoff value of 3.22 yielded sensitivity of 91%, specificity of 100%, and negative predictive value of 89% for detection of neoplasia. Overall diagnostic accuracy was 95%. At a sensitivity of 100%, the most accurate index was the N:S ratio calculated from the first recorded tracing; a cutoff value of 0.45 yielded specificity of 67%, positive predictive value of 81%, and overall diagnostic accuracy of 86.5%.
  
  
  CONCLUSIONS
  Results suggested that noninvasive Doppler spectral analysis may be useful in the diagnosis of neoplastic versus inflammatory peripheral lymphadenopathy in dogs.
authors.affiliation: Dipartimento di Clinica Veterinaria, Facoltà di Medicina Veterinaria, Università di Pisa, Via Livornese, San Piero a Grado (PI), Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Della Santa
authors.forename: Lorrie
authors.initials: L
authors.lastname: Gaschen
authors.forename: Marcus G
authors.initials: MG
authors.lastname: Doherr
authors.forename: Simonetta
authors.initials: S
authors.lastname: Citi
authors.forename: Veronica
authors.initials: V
authors.lastname: Marchetti
authors.forename: Johann
authors.initials: J
authors.lastname: Lang
mesh_terms: D000818:Animals; D001158:Arteries / Q000000981:diagnostic imaging; D001706:Biopsy / Q000662:veterinary; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D004285:Dogs; D005260:Female; D006651:Histocytochemistry / Q000662:veterinary; D008198:Lymph Nodes / Q000098:blood supply*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000662:veterinary*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018615:Ultrasonography, Doppler, Color / Q000662:veterinary*; D018617:Ultrasonography, Doppler, Pulsed / Q000662:veterinary*