Because of its widespread availability and its cost-effectiveness, echocardiography represents the primary method of choice to image the pericardium. However, echocardiography is operator-dependent, and it often fails to detect the entire pericardium. Thus it is limited in the assessment of the severity of pericardial involvement in various diseases affecting the pericardium. Nataf et al. have demonstrated that echocardiography revealed thickened pericardium in only 62% of patients with constrictive pericarditis (1). Additionally, ultrasound cannot penetrate calcifications that occur frequently in patients with constrictive pericarditis.