自动计算触发

2024-04-11 10:41:13 +08:00
parent f415c03daa
commit 6061cf5d93
7 changed files with 288 additions and 77 deletions
@@ -222,7 +222,7 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto

        public Arm ArmEnum { get; set; }

-        public ComputationTrigger ComputationTrigger { get; set; } = ComputationTrigger.Lesion;
+        public ComputationTrigger ComputationTrigger { get; set; } 

        /// <summary>
        /// 是否修改其他任务
@@ -353,7 +353,7 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
        public QuestionType QuestionType { get; set; }


-        public ComputationTrigger? ComputationTrigger { get; set; }
+        public List<ComputationTrigger> ComputationTriggerList { get; set; }=new  List<ComputationTrigger>();

        public Func<ReadingCalculateDto, Task<decimal>> GetDecimalFun { get; set; }

@@ -588,8 +588,9 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
    {
        public Guid VisitTaskId { get; set; }

+		public ComputationTrigger ComputationTrigger { get; set; }

-        public bool UpdateMark { get; set; } = false;
+		public bool UpdateMark { get; set; } = false;

        public List<ChangeDicomReadingQuestionAnswerDto> Answers { get; set; }

@@ -2086,7 +2087,9 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
    {
        public Guid QuestionId { get; set; }

-        public Guid? OrganInfoId { get; set; }
+        public ComputationTrigger ComputationTrigger { get; set; } = ComputationTrigger.CTSave;
+
+		public Guid? OrganInfoId { get; set; }

        public int? NumberOfFrames { get; set; }

@@ -1637,7 +1637,7 @@ namespace IRaCIS.Application.Services
 			{
 				IsChangeOtherTask = false,
 				VisitTaskId = inDto.VisitTaskId,
-				ComputationTrigger = ComputationTrigger.Lesion,
+				ComputationTrigger = ComputationTrigger.MergeLesion,
 			});

 			// 保存完了计算疾病进展
@@ -1746,19 +1746,32 @@ namespace IRaCIS.Application.Services
 		/// 保存任务问题 带动态稽查参数
 		/// </summary>
 		/// <param name="inDto"></param>
+		/// <param name="param">请求类型</param>
 		/// <returns></returns>
 		[Route("/SaveTaskQuestion/{param}")]
 		[HttpPost]
 		public async Task<IResponseOutput> SaveTaskQuestion(ChangeDicomReadingQuestionAnswerInDto inDto, string param)
 		{
 			var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
-			var result = await this.SaveImageQuality(inDto);
-			// 保存脾尖或者脾底进行计算
-			if (taskinfo.TrialReadingCriterion.CriterionType == CriterionType.Lugano2014 && (param == "4" || param == "5"))
-			{
-				await _luganoCalculateService.SaveSplenicCalculate(inDto.VisitTaskId);
-			}
+            try
+            {
+                param = param == string.Empty ? "0" : param;

+                inDto.ComputationTrigger = (ComputationTrigger)int.Parse(param);
+			}
+            catch (Exception)
+            {
+
+            }
+			var result = await this.SaveImageQuality(inDto);
+
+			// 自动计算
+			await this._readingCalculateService.CalculateTask(new CalculateTaskInDto()
+			{
+				IsChangeOtherTask = false,
+				VisitTaskId = inDto.VisitTaskId,
+				ComputationTrigger = inDto.ComputationTrigger,
+			});
 			return result;

 		}
@@ -2055,7 +2068,7 @@ namespace IRaCIS.Application.Services
            {
                IsChangeOtherTask = false,
                VisitTaskId = inDto.VisitTaskId,
-                ComputationTrigger=ComputationTrigger.Lesion,
+                ComputationTrigger=ComputationTrigger.RemoveLesion,
            });


@@ -2078,7 +2091,7 @@ namespace IRaCIS.Application.Services


        /// <summary>
-        /// 提交表格问题答案  提交病灶
+        /// 提交表格问题答案  提交病灶 保存病灶
        /// </summary>
        /// <param name="inDto"></param>
        /// <returns></returns>
@@ -2453,7 +2466,7 @@ namespace IRaCIS.Application.Services
            {
                IsChangeOtherTask = false,
                VisitTaskId = inDto.VisitTaskId,
-                ComputationTrigger = ComputationTrigger.Lesion,
+                ComputationTrigger = inDto.ComputationTrigger,
            });

            // 保存完了计算疾病进展
@@ -154,7 +154,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 						{
 							IsChangeOtherTask = false,
 							VisitTaskId = inDto.VisitTaskId,
-							ComputationTrigger = ComputationTrigger.Report,
+							ComputationTrigger = ComputationTrigger.InitialCalculation,
 						});
 					}
                }
@@ -209,7 +209,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                {
                    await service.CalculateTask(new CalculateTaskInDto()
                    {
-                        ComputationTrigger= ComputationTrigger.Report,
+                        ComputationTrigger= ComputationTrigger.InitialCalculation,
                        VisitTaskId = inDto.VisitTaskId
                    });
                }
@@ -513,88 +513,81 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate

            List<ReadingCalculateData> calculateList = new List<ReadingCalculateData>()
            {
-                /*
-                 * 保存影像质量问题
-                 * 如果：不正常：PET-CT不能融合， FDG-PET的评估设置为NE
-                 * 
-                 * 保存二维页面病灶
-                 * 
-                 * 保存
-                 * 
-                 * 
-                 * 
-                 */
-
                   // 是否存在Pet
-                 new ReadingCalculateData (){QuestionType=QuestionType.ExistPET,GetStringFun=GetExistPET},
+                 new ReadingCalculateData (){QuestionType=QuestionType.ExistPET,GetStringFun=GetExistPET ,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation, } },

                //垂直径乘积之和（SPD）
-				new ReadingCalculateData (){QuestionType=QuestionType.SPD,GetDecimalFun=GetSPD},
+				new ReadingCalculateData (){QuestionType=QuestionType.SPD,GetDecimalFun=GetSPD,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.RemoveLesion,}},

                 // 与基线相比SPD变化的百分比
-			    new ReadingCalculateData (){QuestionType=QuestionType.SPDChange,GetStringFun=CompareBaselineSPD},
+			    new ReadingCalculateData (){QuestionType=QuestionType.SPDChange,GetStringFun=CompareBaselineSPD,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.RemoveLesion,}},
+
+                // 脾脏垂直径
+                  new ReadingCalculateData (){QuestionType=QuestionType.SpleenLength,GetDecimalNullFun=GetSpleenLength,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},

                // 与基线相比脾肿大增加的百分比
-				new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusChange,GetStringFun=GetSplenoncusChange},
+				new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusChange,GetStringFun=GetSplenoncusChange,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},

                // 与最低点相比脾脏垂直径长度的增加值
-                new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusAdd,GetStringFun=GetSplenoncusAdd},
+                new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusAdd,GetStringFun=GetSplenoncusAdd,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},

                // 与基线相比脾垂直径变化值
-                new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusDiameterChange,GetStringFun=GetSplenoncusDiameterChange},
+                new ReadingCalculateData (){QuestionType=QuestionType.SplenoncusDiameterChange,GetStringFun=GetSplenoncusDiameterChange,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},

                // 脾肿垂直径最低点访视
-                new ReadingCalculateData (){QuestionType=QuestionType.LowestSplenoncusVisit,GetStringFun=GetLowestSplenoncusVisit},
+                new ReadingCalculateData (){QuestionType=QuestionType.LowestSplenoncusVisit,GetStringFun=GetLowestSplenoncusVisit,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},
+
+                // 获取脾脏状态
+                  new ReadingCalculateData (){QuestionType=QuestionType.SplenicStatus,GetStringFun=GetSplenicStatus,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,}},

                // 获取脾脏评估
-                new ReadingCalculateData (){QuestionType=QuestionType.SplenicEvaluation,GetStringFun=GetSplenicEvaluation},
+                new ReadingCalculateData (){QuestionType=QuestionType.SplenicEvaluation,GetStringFun=GetSplenicEvaluation,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,ComputationTrigger.SplenicEvaluation,}},

                //靶病灶评估
-			    new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetTargetLesionEvaluate},
+			    new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetTargetLesionEvaluate,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,ComputationTrigger.MergeLesion,}},

 				//非靶病灶评估
-			    new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetNoTargetLesionEvaluate},
+			    new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetNoTargetLesionEvaluate,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

 				//新病灶评估
-			    new ReadingCalculateData (){QuestionType=QuestionType.NewLesionEvaluation,GetStringFun=GetNewLesionEvaluate},
+			    new ReadingCalculateData (){QuestionType=QuestionType.NewLesionEvaluation,GetStringFun=GetNewLesionEvaluate,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

                    //获取肝脏评估
-                 new ReadingCalculateData (){QuestionType=QuestionType.LiverAssessment,GetStringFun=GetLiverAssessment},
+                 new ReadingCalculateData (){QuestionType=QuestionType.LiverAssessment,GetStringFun=GetLiverAssessment,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.LiverStatus,}},

-                  //  // 骨髓中是否存在局灶性 FDG亲和病灶的证据
-                  //new ReadingCalculateData (){QuestionType=QuestionType.EvidenceFocalFDG,GetStringFun=GetEvidenceFocalFDG,ComputationTrigger=ComputationTrigger.Lesion},
+                    // 骨髓中是否存在局灶性 FDG亲和病灶的证据
+                  new ReadingCalculateData (){QuestionType=QuestionType.EvidenceFocalFDG,GetStringFun=GetEvidenceFocalFDG,ComputationTriggerList=new List<ComputationTrigger>(){   }},

                //CT/MRI
-                new ReadingCalculateData (){QuestionType=QuestionType.CTandMRI,GetStringFun=CTMRIEvaluation},
+                new ReadingCalculateData (){QuestionType=QuestionType.CTandMRI,GetStringFun=CTMRIEvaluation,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.LiverStatus,ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,ComputationTrigger.SplenicEvaluation,ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,ComputationTrigger.MergeLesion,}},

                // PET 5PS评分
-                new ReadingCalculateData (){QuestionType=QuestionType.PET5PS,GetStringFun=GetPET5PS,ComputationTrigger=ComputationTrigger.Lesion},
+                new ReadingCalculateData (){QuestionType=QuestionType.PET5PS,GetStringFun=GetPET5PS,ComputationTriggerList=new List<ComputationTrigger>(){  ComputationTrigger.ImageQuality, ComputationTrigger.LiverBloodPool,ComputationTrigger.MediastinalPool,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,} },

                // 修改PET 5PS评分备注
-			   new ReadingCalculateData (){QuestionType=QuestionType.PSScoreRemarks,GetStringFun=GetPET5PSRemark,ComputationTrigger=ComputationTrigger.Lesion},
+			   new ReadingCalculateData (){QuestionType=QuestionType.PSScoreRemarks,GetStringFun=GetPET5PSRemark,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.LiverBloodPool,ComputationTrigger.MediastinalPool,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

                //与基线相比摄取值变化
-                new ReadingCalculateData (){QuestionType=QuestionType.UptakeChange,GetStringFun=GetUptakeChange,ComputationTrigger=ComputationTrigger.Lesion},
+                new ReadingCalculateData (){QuestionType=QuestionType.UptakeChange,GetStringFun=GetUptakeChange,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.LiverBloodPool,ComputationTrigger.MediastinalPool,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

                // FDG-PET 评估结果
-                 new ReadingCalculateData (){QuestionType=QuestionType.FDGPET,GetStringFun=GetFDGPETOverallAssessment},
+                 new ReadingCalculateData (){QuestionType=QuestionType.FDGPET,GetStringFun=GetFDGPETOverallAssessment,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation, ComputationTrigger.ImageQuality, ComputationTrigger.LiverBloodPool,ComputationTrigger.MediastinalPool,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,ComputationTrigger.PDGPET,}},

                   // 上一次 FDG-PET 评估结果
-                 new ReadingCalculateData (){QuestionType=QuestionType.LastFDGPET,GetStringFun=GetLastFDGPETOverallAssessment},
+                 new ReadingCalculateData (){QuestionType=QuestionType.LastFDGPET,GetStringFun=GetLastFDGPETOverallAssessment,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

                 // 影像学整体肿瘤评估
-                 new ReadingCalculateData (){QuestionType=QuestionType.ImgOncology,GetStringFun=GetImgOncology},
+                 new ReadingCalculateData (){QuestionType=QuestionType.ImgOncology,GetStringFun=GetImgOncology,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.LiverStatus,ComputationTrigger.SplenicApexPosition,ComputationTrigger.PositionSpleenFloor,ComputationTrigger.SplenicEvaluation,ComputationTrigger.LiverBloodPool,ComputationTrigger.MediastinalPool,ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,ComputationTrigger.PDGPET,ComputationTrigger.MergeLesion,}},

-             
                     //SUVmax
-                 new ReadingCalculateData (){QuestionType=QuestionType.SUVmax,GetDecimalNullFun=GetSuvMax},
+                 new ReadingCalculateData (){QuestionType=QuestionType.SUVmax,GetDecimalNullFun=GetSuvMax,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},

                 // SUVmax所在病灶
-                 new ReadingCalculateData (){QuestionType=QuestionType.SUVmaxLesion,GetStringFun=GetSuvMaxFocus},
+                 new ReadingCalculateData (){QuestionType=QuestionType.SUVmaxLesion,GetStringFun=GetSuvMaxFocus,ComputationTriggerList=new List<ComputationTrigger>(){   ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},


                 	 //是否存在疾病
-			    new ReadingCalculateData (){QuestionType=QuestionType.ExistDisease,GetStringFun=GetIsExistDisease},
+			    new ReadingCalculateData (){QuestionType=QuestionType.ExistDisease,GetStringFun=GetIsExistDisease,ComputationTriggerList=new List<ComputationTrigger>(){ ComputationTrigger.InitialCalculation,  ComputationTrigger.CTSave,ComputationTrigger.MergeSave,ComputationTrigger.RemoveLesion,}},
             

               
@@ -681,7 +674,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
            }


-            calculateList = calculateList.Where(x => x.ComputationTrigger == null || x.ComputationTrigger == inDto.ComputationTrigger).ToList();
+            calculateList = calculateList.Where(x =>x.ComputationTriggerList.Contains(inDto.ComputationTrigger)).ToList();
            var typeNAList = new List<QuestionType>
            {
                QuestionType.SODChange,
@@ -2046,13 +2039,42 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate

        #endregion

-        #region 与基线相比SPD变化的百分比
+        #region 脾脏垂直径
        /// <summary>
-        /// 与基线相比SPD变化的百分比
+        /// 获取脾脏垂直径
        /// </summary>
        /// <param name="inDto"></param>
        /// <returns></returns>
-        public async Task<string> CompareBaselineSPD(ReadingCalculateDto inDto)
+        public async Task<decimal?> GetSpleenLength(ReadingCalculateDto inDto)
+        {
+
+			// 脾尖答案
+			var splenicTopAnswer = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SplenicTopPosition).Select(x => x.Answer).FirstOrDefault();
+			// 脾底答案
+			var splenicBottomAnswer = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SplenicBottomPosition).Select(x => x.Answer).FirstOrDefault();
+
+            decimal? spleenLength=null;
+			if (splenicTopAnswer != null && splenicBottomAnswer != null)
+			{
+				spleenLength = splenicTopAnswer.IsNullOrEmptyReturn0() - splenicBottomAnswer.IsNullOrEmptyReturn0();
+				if (spleenLength < 0)
+				{
+					spleenLength = 0 - spleenLength;
+				}
+                return spleenLength;
+			}
+
+            return spleenLength;
+		}
+		#endregion
+
+		#region 与基线相比SPD变化的百分比
+		/// <summary>
+		/// 与基线相比SPD变化的百分比
+		/// </summary>
+		/// <param name="inDto"></param>
+		/// <returns></returns>
+		public async Task<string> CompareBaselineSPD(ReadingCalculateDto inDto)
        {
            if (inDto.IsBaseLine)
            {
@@ -2400,6 +2422,23 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
           
        }

+        /// <summary>
+        /// 获取脾脏状态
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetSplenicStatus(ReadingCalculateDto inDto)
+        {
+            var spleenLength= inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SpleenLength).Select(x => x.Answer).FirstOrDefault();
+            if (spleenLength == string.Empty)
+            {
+                return string.Empty;
+            }
+            else
+            {
+				return await GetSplenicState(inDto.VisitTaskId, spleenLength.IsNullOrEmptyReturn0());
+			}
+		}

 		#region 获取脾脏评估

@@ -2488,12 +2527,52 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
        /// <returns></returns>
        public async Task<string> GetPET5PS(ReadingCalculateDto inDto)
        {
-            //病灶最大SUVmax、肝脏血池、纵膈血池SUVmax未发生改变时，不用计算
+
+			// 如果是保存影像进来 PET-CT不能融合  就是NE
+			if (inDto.ComputationTrigger == ComputationTrigger.ImageQuality)
+            {
+                if (await ImageQualityIsUnableFuse(inDto))
+                {
+                    return PET5PSScore.NE.GetEnumInt();
+				}
+            }
+
+            // 如果不是保存肝脏血池和纵隔血池
+            if (inDto.ComputationTrigger != ComputationTrigger.LiverBloodPool && inDto.ComputationTrigger != ComputationTrigger.MediastinalPool)
+            {
+				// 先在数据库查这几个值
+				List<QuestionType?> needSearchTypes = new List<QuestionType?>()
+			{
+				QuestionType.SUVmax,
+				QuestionType.PET5PS,
+			};
+
+				var dataBaseDataList = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && needSearchTypes.Contains(x.ReadingQuestionTrial.QuestionType)).Select(x => new
+				{
+					x.Answer,
+					x.ReadingQuestionTrial.QuestionType
+				}).ToListAsync(); ;
+
+
+				// 数据库中最大SUVmax
+				var dataBaseSUVmax = dataBaseDataList.Where(x => x.QuestionType == QuestionType.SUVmax).Select(x => x.Answer).FirstIsNullReturnEmpty();
+
+				// 如果SUVmax没变 就不重新计算
+				if (dataBaseSUVmax == (await GetSuvMax(inDto)).ToString())
+                {
+                    return dataBaseDataList.Where(x => x.QuestionType == QuestionType.PET5PS).Select(x => x.Answer).FirstIsNullReturnEmpty();
+
+				}
+
+			}
+		
+
+
 			//if (inDto.IsBaseLine)
 			//{
 			//    return SpleenAssessment.Stabilization.GetEnumInt();
 			//}
-		
+
 			if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.ExistPET && x.Answer == ReadingYesOrNo.No.GetEnumInt()))
            {
                return PET5PSScore.NE.GetEnumInt();
@@ -2577,8 +2656,33 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 		/// <returns></returns>
 		public async Task<string> GetUptakeChange(ReadingCalculateDto inDto)
        {
-            //PET5ps评分改变时，才计算
-            if (inDto.IsBaseLine)
+			//PET5ps评分改变时，才计算
+
+			List<QuestionType?> needSearchTypes = new List<QuestionType?>()
+			{
+				QuestionType.PET5PS,
+				QuestionType.UptakeChange,
+			};
+
+			var dataBaseDataList = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && needSearchTypes.Contains(x.ReadingQuestionTrial.QuestionType)).Select(x => new
+			{
+				x.Answer,
+				x.ReadingQuestionTrial.QuestionType
+			}).ToListAsync(); ;
+
+
+			// 数据库中PET5ps评分
+			var dataBasePET5ps = dataBaseDataList.Where(x => x.QuestionType == QuestionType.PET5PS).Select(x => x.Answer).FirstIsNullReturnEmpty();
+
+		
+            if (dataBasePET5ps == await GetPET5PS(inDto))
+            {
+				return dataBaseDataList.Where(x => x.QuestionType == QuestionType.UptakeChange).Select(x => x.Answer).FirstIsNullReturnEmpty();
+
+			}
+
+
+			if (inDto.IsBaseLine)
            {
                return SUVChangeVSBaseline.NA.GetEnumInt();
            }
@@ -2658,7 +2762,23 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
        public async Task<string> GetFDGPETOverallAssessment(ReadingCalculateDto inDto)
        {

-            if (inDto.IsBaseLine)
+			// 如果是保存影像进来 PET-CT不能融合  就是NE
+			if (inDto.ComputationTrigger == ComputationTrigger.ImageQuality)
+			{
+				if (await ImageQualityIsUnableFuse(inDto))
+				{
+                    if (inDto.IsBaseLine)
+                    {
+                        return FDGPETOverallAssessment.NA.GetEnumInt();
+                    }
+                    else
+                    {
+						return FDGPETOverallAssessment.NE.GetEnumInt();
+					}
+				}
+			}
+
+			if (inDto.IsBaseLine)
            {
                return FDGPETOverallAssessment.NA.GetEnumInt();
            }