Oxygenation-sensitive cardiac magnetic resonance imaging

Abstract

Oxygenation-sensitive cardiac magnetic resonance imaging (OS-CMR) is an evolving cardiac imaging technique offering new perspectives to understand, predict, and diagnose cardiac pathologies. To provide an overview of the basic principles of OS-CMR, the current diagnostic applications and how it may aid in future diagnostic challenges. Description, analysis, and interpretation of the current literature on basic research and applicational studies in both humans and animals assessing OS-CMR. OS-CMR is based on the paramagnetic properties of deoxygenated hemoglobin, which is visualized by aT2*-sensitive sequence. The measured signal correlates with the oxygenation of the myocardium and can analyze vascular function during pharmacological vasodilation or vasoactive breathing exercises (hyperventilation, apnea). The herewith triggered changes in myocardial oxygenation and oxygenation reserve can be used to identify relevant stenoses in coronary artery disease. Other areas of application involve myocardial hypertrophy, microvascular dysfunction, and pulmonary hypertension. A broad number of applications for the clinical use of OS-CMR exist so far, especially in combination with breathing exercises. OS-CMR can be conducted medication- and needle-free. Limitations involve the current lack of clinically approved, automated evaluation tools and the unavailability of vendor- and site-independent normal values.