Any molecule used to measure organ perfusion in conjunction with imaging.
Characteristics of good perfusion agents:
Perfusion agents used in MRI are small Gd-chelates (they do not cross blood brain barrier, but extravasate quickly into extracellular space in other organs) and SPIOS.

(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.

(ASL) A MR image can be sensitized to the effect of inflowing blood spins if those spins are in a different magnetic state to that of the static tissue. Techniques known as ASL techniques uses this idea by magnetically labeling blood flowing into the slices of interest. Contrast agents are not required for these techniques. This perfusion measurement is completely noninvasive.
Blood flowing into the imaging slice exchanges with tissue water, altering the tissue magnetization. A perfusion-weighted image can be generated by the subtraction of an image in which inflowing spins have been labeled from an image in which spin labeling has not been performed. Quantitative perfusion maps can be calculated if other parameters (such as tissue T1 and the efficiency of spin labeling) also are measured.

Macromolecular Gd labeled albumins are a new class of contrast agents with a wide range of use e.g., MR angiography, breast MRI, perfusion MRI, Lung perfusion, etc.
Marketed gadolinium-based albumin-bound contrast media are e.g., MultiHance®, and Vasovist™; other prototypes are in development. Malignant tumors often show an increased uptake and metabolism of plasma proteins, especially albumin. Contrast agents with large molecules are delivered to all tissues, but only accumulate in those with leaky vessels by tumor capillaries (tumor neovessels). MRI tumor perfusion studies with Gd labeled albumin can show the success of tumor therapy by quantitative decrease in MR signal of the malignant tissue after therapy compared to before. In addition, the study of tumor sensitivity to a therapy with drug-labeled albumins seems possible.
After renal transplantation, MRI may diagnose albuminuria caused by glomerular disease with an albumin-bound blood pool contrast agent

See also Blood Pool Agents, Intravascular Contrast Agents, Contrast Enhanced MRI.

Cardiovascular MR imaging includes the complete anatomical display of the heart with CINE imaging of all phases of the heartbeat. Ultrafast techniques make breath hold three-dimensional coverage of the heart in different cardiac axes feasible. Cardiac MRI provides reliable anatomical and functional assessment of the heart and evaluation of myocardial viability and coronary artery disease by a noninvasive diagnostic imaging technique.
Cardiovascular MRI offers potential advantages over radioisotopic techniques because it provides superior spatial resolution, does not use ionizing radiation, has no imaging orientations constraints and contrast resolution better than echocardiography. It also offers direct visualization and characterization of atherosclerotic plaques and diseased vessel walls and surrounding tissues in cardiovascular research.
MRI perfusion approaches measure the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents and assess the extent of injury after a myocardial infarction and the presence of myocardial viability with a technique based on late enhancement. Extracellular MRI contrast agents, like Gd-DTPA, accumulate only in irreversibly damaged myocardium after a time period of at least 10 minutes.
This type of patients may also have an implanted cardiac stent, bypass or a cardiac pacemaker and special caution should be observed on the MRI safety and the contraindications. While a number of coronary stents have been tested and reported to be MRI compatible, coronary stents must be assessed on an individual basis, with the medical team weighing the risks and benefits of the MRI procedure.

Cardiac MRI overview:

Cardiovascular MRI has become one of the most effective noninvasive imaging techniques for almost all groups of heart and vascular disease.