diff --git a/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs b/IRaCIS.Core.Application/Service/Common/Export/TumorExportService.cs
similarity index 98%
rename from IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs
rename to IRaCIS.Core.Application/Service/Common/Export/TumorExportService.cs
index 20cc0b291..d9c286224 100644
--- a/IRaCIS.Core.Application/Service/Common/Export/RESISTExportService.cs
+++ b/IRaCIS.Core.Application/Service/Common/Export/TumorExportService.cs
@@ -383,7 +383,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
 
         var dicNameList = taskList.SelectMany(t => t.QuestionAnswerList).Select(t => t.TranslateDicName)
          .Union(taskList.SelectMany(t => t.LesionList).SelectMany(t => t.LessionAnswerList).Where(t => t.TranslateDicName.IsNotNullOrEmpty()).Select(c => c.TranslateDicName))
-         .Union(new List<string>() { "ArmEnum", "ValueUnit", "GlobalAssessType" })
+         .Union(new List<string>() { "ArmEnum", "ValueUnit", "GlobalAssessType", "ImageQualityIssues" })
          .Distinct().ToArray();
 
         //翻译字典
@@ -424,6 +424,8 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
                 {
                     var visiTaskId = vTaskGroup.Key;
 
+                    var globalVisitName = tuList.Where(t => t.VisitNum == task.VisitNum - ReadingCommon.TaskNumDic[ReadingCategory.Global]).FirstOrDefault()?.VisitName ?? "";
+
                     var reason = vTaskGroup.FirstOrDefault()?.Answer ?? "";
 
                     var firstTuTask = tuList.FirstOrDefault(t => t.VisitTaskId == visiTaskId);
@@ -433,7 +435,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
 
                         var co = CreatNewCOExport(task, coList.Count + 1);
 
-                        co.RemarksQuote = $"{co.ArmEnumStr}_{co.TaskName}";
+                        co.RemarksQuote = $"{co.ArmEnumStr}_{globalVisitName}_ GLOBAL_COMMENTS";
 
                         co.VisitNum = firstTuTask.VisitNum;
 
@@ -714,11 +716,25 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
 
                 #region   co 处理部分 处理部分1  质量备注
 
-                if (questionAnswer.QuestionType == QuestionType.ImageQualityAssessment)
+                if (questionAnswer.QuestionType == QuestionType.ImageQualityAssessment ||
+                    questionAnswer.QuestionType == QuestionType.ImageQualityProblem ||
+                    questionAnswer.QuestionType == QuestionType.ImageQualityProblemComment)
                 {
                     var co = CreatNewCOExport(task, coList.Count + 1);
 
-                    co.RemarksQuote = $"{co.ArmEnumStr}_{co.TaskName}";
+
+                    switch (questionAnswer.QuestionType)
+                    {
+                        case QuestionType.ImageQualityAssessment:
+                            co.RemarksQuote = $"{co.ArmEnumStr}__QUALITY";
+                            break;
+                        case QuestionType.ImageQualityProblem:
+                            co.RemarksQuote = $"{co.ArmEnumStr}_QUALITY_ISSUE";
+                            break;
+                        case QuestionType.ImageQualityProblemComment:
+                            co.RemarksQuote = $"{co.ArmEnumStr}_QUALITY_COMMETS";
+                            break;
+                    }
 
                     if (questionAnswer.TranslateDicName.IsNotNullOrEmpty())
                     {
@@ -754,7 +770,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
                     co.RDOMAIN = "RS";
                     co.IdentificationVariable = "RSSEQ";
                     co.Identification = rs_Tumor.RSSEQ.ToString();
-                    co.RemarksQuote = $"{co.ArmEnumStr}_{co.VisitName}";
+                    co.RemarksQuote = $"{co.ArmEnumStr}_VISIT_COMMENTS";
                     co.Remarks = task.VisitNote;
 
                     coList.Add(co);
@@ -766,7 +782,7 @@ public class Tumor_CDISC_ExportService(IRepository<ReadingQuestionCriterionTrial
             {
                 var co = CreatNewCOExport(task, coList.Count + 1);
 
-                co.RemarksQuote = $"{co.ArmEnumStr}_{co.VisitName}";
+                co.RemarksQuote = $"{co.VisitName}_ADJUDICATION_COMMENTS";
                 co.Remarks = task.JudgeNote;
                 co.CODTC = task.JudgeSignTime?.ToString("yyyy-MM-dd");
 
diff --git a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
index 291619cb4..542480da4 100644
--- a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
+++ b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
@@ -2793,6 +2793,11 @@ public enum SUVChangeVSBaseline
 		/// </summary>
 		ImageQualityProblem = 67,
 
+        /// <summary>
+        /// 影像质量问题备注
+        /// </summary>
+        ImageQualityProblemComment = 68,
+
         /// <summary>
         /// 斑块1-PAV
         /// </summary>