The current state of myocardial Blood-Oxygen-Level-Dependent (BOLD) MRI with balanced steady-state free
precession (SSFP) approaches is reviewed. Initial studies forming the basis for SSFP-based detection of oxygenation
changes beginning with whole blood studies, progressing through controlled studies that consider microcirculatory
changes in oxygenation in skeletal muscle and kidney, culminating in basic myocardial studies are outlined. The
theoretical basis to observe signal changes and the mechanisms that facilitate such observations are elucidated. Methods to
overcome limitations in sensitivity are described.