(BOLD) In MRI the changes in blood oxygenation level are visible. Oxyhaemoglobin (the principal haemoglobin in arterial blood) has no substantial magnetic properties, but deoxyhaemoglobin (present in the draining veins after the oxygen has been unloaded in the tissues) is strongly paramagnetic. It can thus serve as an intrinsic paramagnetic contrast agent in appropriately performed brain MRI. The concentration and relaxation properties of deoxyhaemoglobin make it a susceptibility , e.g. T2 relaxation effective contrast agent with little effect on T1 relaxation.
During activation of the brain, the oxygen consumption of the local tissue increase by approximately 5% with that the oxygen tension will decrease. As a consequence, after a short period of time vasodilatation occurs, resulting in a local increase of blood volume and flow by 20 - 40%. The incommensurate change in local blood flow and oxygen extraction increases the local oxygen level.
By using T2 weighted gradient echo EPI sequences, which are highly susceptibility sensitive and fast enough to capture the three-dimensional nature of activated brain areas will show an increase in signal intensity as oxyhaemoglobin is diamagnetic and deoxyhaemoglobin is paramagnetic. Other MR pulse sequences, such as spoiled gradient echo pulse sequences are also used.
As the effects are subtle and of the order of 2% in 1.5 T MR imaging, sophisticated methodology, paradigms and data analysis techniques have to be used to consistently demonstrate the effect.
As the BOLD effect is due to the deoxygenated blood in the draining veins, the spatial localization of the region where there is increased blood flow resulting in decreased oxygen extraction is not as precisely defined as the morphological features in MRI. Rather there is a physiological blurring, and is estimated that the linear dimensions of the physiological spatial resolution of the BOLD phenomenon are around 3 mm at best.

Flow phenomena are intrinsic processes in the human body. Organs like the heart, the brain or the kidneys need large amounts of blood and the blood flow varies depending on their degree of activity. Magnetic resonance imaging has a high sensitivity to flow and offers accurate, reproducible, and noninvasive methods for the quantification of flow. MRI flow measurements yield information of blood supply of of various vessels and tissues as well as cerebro spinal fluid movement.
Flow can be measured and visualized with different pulse sequences (e.g. phase contrast sequence, cine sequence, time of flight angiography) or contrast enhanced MRI methods (e.g. perfusion imaging, arterial spin labeling).
The blood volume per time (flow) is measured in: cm3/s or ml/min. The blood flow-velocity decreases gradually dependent on the vessel diameter, from approximately 50 cm per second in arteries with a diameter of around 6 mm like the carotids, to 0.3 cm per second in the small arterioles.

Different flow types in human body:
See also Flow Effects, Flow Artifact, Flow Quantification, Flow Related Enhancement, Flow Encoding, Flow Void, Cerebro Spinal Fluid Pulsation Artifact, Cardiovascular Imaging and Cardiac MRI.

(MRA) Magnetic resonance angiography is a medical imaging technique to visualize blood filled structures, including arteries, veins and the heart chambers. This MRI technique creates soft tissue contrast between blood vessels and surrounding tissues primarily created by flow, rather than displaying the vessel lumen. There are bright blood and black blood MRA techniques, named according to the appearance of the blood vessels. With this different MRA techniques both, the blood flow and the condition of the blood vessel walls can be seen. Flow effects in MRI can produce a range of artifacts. MRA takes advantage of these artifacts to create predictable image contrast due to the nature of flow.
Technical parameters of the MRA sequence greatly affect the sensitivity of the images to flow with different velocities or directions, turbulent flow and vessel size.
This are the three main types of MRA:
All angiographic techniques differentially enhance vascular MR signal. The names of the bright blood techniques TOF and PCA reflect the physical properties of flowing blood that were exploited to make the vessels appear bright. Contrast enhanced magnetic resonance angiography creates the angiographic effect by using an intravenously administered MR contrast agent to selectively shorten the T1 of blood and thereby cause the vessels to appear bright on T1 weighted images.
MRA images optimally display areas of constant blood flow-velocity, but there are many situations where the flow within a voxel has non-uniform speed or direction. In a diseased vessel these patterns are even more complex. Similar loss of streamline flow occurs at all vessel junctions and stenoses, and in regions of mural thrombosis. It results in a loss of signal, due to the loss of phase coherence between spins in the voxel.
This signal loss, usually only noticeable distal to a stenosis, used to be an obvious characteristic of MRA images. It is minimized by using small voxels and the shortest possible TE. Signal loss from disorganized flow is most noticeable in TOF imaging but also affects the PCA images.
Indications to perform a magnetic resonance angiography (MRA):
Conventional angiography or computerized tomography angiography (CT angiography) may be needed after MRA if a problem (such as an aneurysm) is present or if surgery is being considered.

See also Magnetic Resonance Imaging MRI.

(PWI - Perfusion Weighted Imaging) Perfusion MRI techniques (e.g. PRESTO - Principles of Echo Shifting using a Train of Observations) are sensitive to microscopic levels of blood flow. Contrast enhanced relative cerebral blood volume (rCBV) is the most used perfusion imaging. Both, the ready availability and the T2* susceptibility effects of gadolinium, rather than the T1 shortening effects make gadolinium a suitable agent for use in perfusion imaging. Susceptibility here refers to the loss of MR signal, most marked on T2* (gradient echo)-weighted and T2 (spin echo)-weighted sequences, caused by the magnetic field-distorting effects of paramagnetic substances.
T2* perfusion uses dynamic sequences based on multi or single shot techniques. The T2* (T2) MRI signal drop within or across a brain region is caused by spin dephasing during the rapid passage of contrast agent through the capillary bed. The signal decrease is used to compute the relative perfusion to that region. The bolus through the tissue is only a few seconds, high temporal resolution imaging is required to obtain sequential images during the wash in and wash out of the contrast material and therefore, resolve the first pass of the tracer. Due to the high temporal resolution, processing and calculation of hemodynamic maps are available (including mean transit time (MTT), time to peak (TTP), time of arrival (T0), negative integral (N1) and index.
An important neuroradiological indication for MRI is the evaluation of incipient or acute stroke via perfusion and diffusion imaging. Diffusion imaging can demonstrate the central effect of a stroke on the brain, whereas perfusion imaging visualizes the larger 'second ring' delineating blood flow and blood volume. Qualitative and in some instances quantitative (e.g. quantitative imaging of perfusion using a single subtraction) maps of regional organ perfusion can thus be obtained.
Echo planar and potentially echo volume techniques together with appropriate computing power offer real time images of dynamic variations in water characteristics reflecting perfusion, diffusion, oxygenation (see also Oxygen Mapping) and flow.
Another type of perfusion MR imaging allows the evaluation of myocardial ischemia during pharmacologic stress. After e.g., adenosine infusion, multiple short axis views (see cardiac axes) of the heart are obtained during the administration of gadolinium contrast. Ischemic areas show up as areas of delayed and diminished enhancement. The MRI stress perfusion has been shown to be more accurate than nuclear SPECT exams. Myocardial late enhancement and stress perfusion imaging can also be performed during the same cardiac MRI examination.

(PCA) With this method images of the blood flow-velocity (or any other movement of tissue) are produced. The MRI signal contains both amplitude and phase information. The phase information can be used with subtraction of images with and without a velocity encoding gradient. The signal will be directly proportional to the velocity because of the relation between blood flow-velocity and signal intensity.
This is the strength of PCA, complete suppression of stationary tissue (no velocity - no signal), the direct velocity of flow is being imaged, while in TOF (Inflow) angiography, tissue with short T1 (fat or methaemoglobin) might be visualized.
The strength of the gradient determines the sensitivity to flow. It is set by setting the aliasing or encoding velocity (VENC). Unfortunately, phase sensitization can only be acquired along one axis at a time. Therefore, phase contrast angiographic techniques tend to be 4 times slower than TOF techniques with the same matrix.

See also Phase Contrast Sequence, Magnetic Resonance Angiography, Contrast Enhanced Magnetic Resonance Angiography, Flow Effects and Flow Quantification.