DeSmet A A, Fryback D G, Thornbury J R
AJR Am J Roentgenol. 1979 Jan;132(1):95-9. doi: 10.2214/ajr.132.1.95.
A prospective study tested the hypothesis of Bell and Loop (1971) that 21 high yield findings are significantly associated with the presence of a skull fracture and can be used to decide which patients need skull radiography. In our study, 17 fractures were detected in 594 patients who had skull radiography because of trauma to the head. Six of these fractures occurred in children who had none of the 21 Bell and Loop high yield findings. These six patients were asymptomatic except for superficial injury at the site of trauma. Had the Bell and Loop criteria been used to decide which patients had skull radiography, 35% (all in children) of the fractures would have gone undetected. Thus, in our study population, the Bell and Loop high yield findings were not satisfactory criteria for the decision about obtaining skull films in children.
一项前瞻性研究检验了贝尔和卢普（1971年）的假设，即21项高收益发现与颅骨骨折的存在显著相关，可用于决定哪些患者需要进行颅骨X光检查。在我们的研究中，594名因头部外伤而接受颅骨X光检查的患者中检测出17处骨折。其中6处骨折发生在没有贝尔和卢普21项高收益发现中的任何一项的儿童身上。这6名患者除了创伤部位有浅表损伤外没有任何症状。如果使用贝尔和卢普的标准来决定哪些患者进行颅骨X光检查，35%（全部为儿童）的骨折将无法被检测到。因此，在我们的研究人群中，贝尔和卢普的高收益发现并不是决定儿童是否需要拍摄颅骨X光片的令人满意的标准。
