Myocardial oxygenation assessment at myocardial blood oxygen level-dependent MRI : a fresh look at an old promise

© 2020 Radiological Society of North AmericaMyocardial ischemia occurs when blood flow to the heart is obstructed, leading to reduced perfusion and tissue hypoxia. It is a major issue in cardiovascular diseases with clinical, diagnostic, and prognostic implications. Cardiac MRI and other modalities can help to assess ischemia, identify perfusion defects (the first in the ischemic cascade), and depict wall motion abnormalities related to coronary obstructive stenosis. Blood oxygen level–dependent (BOLD) cardiac MRI is a tool for ischemia diagnosis that has the potential to determine the level of myocardial oxygenation and help identify hypoxic segments from the formation of deoxyhemoglobin, which is paramagnetic and may act as an endogenous contrast agent (ie, reduced T2 and T2*).