diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
index c2373fe8d..8fcfa0e0e 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
@@ -766,7 +766,11 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         /// <returns></returns>
         public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto)
         {
+            if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt()))
+            {
 
+                return;
+            }
             var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null)
       && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State
       )
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
index 845f43f6e..f396c0497 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
@@ -1027,6 +1027,13 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
         public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto)
         {
+
+            if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt()))
+            {
+
+                return;
+            }
+
             var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null)
        && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State
        )
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
index 85eee1514..c44e8815c 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
@@ -633,6 +633,13 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto)
         {
 
+            if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt()))
+            {
+
+                return;
+            }
+          
+
             var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null)
       && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State
       )
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
index 3fd7eecc2..bd528675f 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
@@ -629,6 +629,12 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto)
         {
 
+            if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt()))
+            {
+
+                return;
+            }
+
             var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null)
       && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State
       )
diff --git a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
index 7ed9a7783..e17780ed5 100644
--- a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
+++ b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
@@ -16,11 +16,26 @@ namespace IRaCIS.Core.Domain.Share
         public static readonly string Group = "group";
     }
 
+    /// <summary>
+    /// 影像质量评估
+    /// </summary>
+    public enum ImageQualityEvaluation
+    {
+        /// <summary>
+        /// 正常
+        /// </summary>
+        Normal = 1,
 
-	/// <summary>
-	/// 语言类型
-	/// </summary>
-	public enum LanguageType
+        /// <summary>
+        /// 不正常
+        /// </summary>
+        Abnormal = 2,
+    }
+
+    /// <summary>
+    /// 语言类型
+    /// </summary>
+    public enum LanguageType
 	{
 
 		/// <summary>
@@ -1490,7 +1505,12 @@ namespace IRaCIS.Core.Domain.Share
         /// </summary>
         IsBrainMetastasis =43,
 
-       
+        /// <summary>
+        /// 影像质量评估
+        /// </summary>
+        ImageQualityAssessment=44,
+
+
     }
 
     /// <summary>