Table VI.

Indirect signals of pouch of Douglas (cul de sac) endometriosis.

Signs	Characteristics
Loss of Tissues Interface	Disappearance of the fat tissue that separates anatomical structures (MRI) Hypointense thickening bands with distortion of surrounding organs on T2-W (MRI)
Thickening Bands Appearance	Retroflexed uterus (US - MRI)	Rectum tethered appearance (MRI)
Obliteration Signals	Elevation of posterior fornix (US - MRI) Strands between uterus and bowel (US - MRI)	Fibrotic plaque covering uterine serosa (US - MRI) Asymmetrical thickness of USL giving an archiform and tether appearance (US - MRI )