diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
index 25a2cab0f..61420fdeb 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
@@ -9,10 +9,68 @@ using System.Threading.Tasks;
 
 namespace IRaCIS.Core.Application.Service.Reading.Dto
 {
+
+    public class IRConfirmMedicalReviewInDto
+    {
+        public Guid TaskMedicalReviewId { get; set; }
+
+        /// <summary>
+        /// 阅片人是否认同
+        /// </summary>
+        public MedicalReviewDoctorUserIdea DoctorUserIdeaEnum { get; set; }
+
+
+        /// <summary>
+		/// 不同意重阅原因
+		/// </summary>
+		public string DisagreeReason { get; set; } = string.Empty;
+
+
+        /// <summary>
+        /// 是否申请重阅
+        /// </summary>
+        public bool IsApplyHeavyReading { get; set; } = false;
+    }
+
     public class FinishMedicalReviewInDto
     {
         public Guid TaskMedicalReviewId { get; set; }
     }
+
+
+    public class GetMedicalReviewDialogOutDto
+    {
+        /// <summary>
+        /// 对话内容
+        /// </summary>
+        public string Content { get; set; }
+
+        /// <summary>
+        /// 用户角色
+        /// </summary>
+        public string UserTypeShortName { get; set; }
+
+        /// <summary>
+        /// 用户角色枚举
+        /// </summary>
+        public int UserTypeEnumInt { get; set; }
+
+        /// <summary>
+        /// 创建人
+        /// </summary>
+        public Guid CreateUserId { get; set; }
+
+        /// <summary>
+        /// 创建时间
+        /// </summary>
+        public DateTime CreateTime { get; set; }
+    }
+
+    public class GetMedicalReviewDialogInDto
+    {
+        [NotDefault]
+        public Guid TaskMedicalReviewId { get; set; }
+    }
     public class SendMedicalReviewDialogInDto
     {
         public Guid TaskMedicalReviewId { get; set; }
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
index 83d1c8430..b9d0f7dec 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
@@ -299,6 +299,29 @@ namespace IRaCIS.Core.Application.Service
             return ResponseOutput.Result(result);
         }
 
+        /// <summary>
+        /// 获取医学审核对话
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        [HttpPost]
+        public async Task<List<GetMedicalReviewDialogOutDto>> GetMedicalReviewDialog(GetMedicalReviewDialogInDto inDto)
+        {
+            List<GetMedicalReviewDialogOutDto> result = await _readingMedicalReviewDialogRepository.Where(x => x.TaskMedicalReviewId == inDto.TaskMedicalReviewId)
+                .Select(x => new GetMedicalReviewDialogOutDto()
+                {
+
+                    Content = x.Content,
+                    CreateTime = x.CreateTime,
+                    CreateUserId = x.CreateUserId,
+                    UserTypeEnumInt = x.UserTypeEnumInt,
+                    UserTypeShortName = x.UserTypeShortName,
+
+                }).OrderBy(x => x.CreateTime).ToListAsync();
+
+            return result;
+        }
+
         /// <summary>
         /// 完成医学审核
         /// </summary>
@@ -308,6 +331,8 @@ namespace IRaCIS.Core.Application.Service
         public async Task<IResponseOutput> FinishMedicalReview(FinishMedicalReviewInDto inDto)
         {
 
+
+
             await _taskMedicalReviewRepository.UpdatePartialFromQueryAsync(inDto.TaskMedicalReviewId, x => new TaskMedicalReview()
             {
                 AuditState = MedicalReviewAuditState.HaveSigned,
@@ -318,7 +343,24 @@ namespace IRaCIS.Core.Application.Service
             return ResponseOutput.Result(result);
         }
 
+        /// <summary>
+        /// IR回复确认医学审核
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        [HttpPost]
+        public async Task<IResponseOutput> IRConfirmMedicalReview(IRConfirmMedicalReviewInDto inDto)
+        {
+            await _taskMedicalReviewRepository.UpdatePartialFromQueryAsync(inDto.TaskMedicalReviewId, x => new TaskMedicalReview()
+            {
+                DoctorUserIdeaEnum = inDto.DoctorUserIdeaEnum,
+                DisagreeReason = inDto.DisagreeReason,
+                IsApplyHeavyReading=inDto.IsApplyHeavyReading,
+            });
 
+            var result = await _taskMedicalReviewRepository.SaveChangesAsync();
+            return ResponseOutput.Result(result);
+        }
 
 
     }
diff --git a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
index 861571f7a..129d276bc 100644
--- a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
+++ b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
@@ -116,6 +116,18 @@ namespace IRaCIS.Core.Domain.Models
 		public DateTime? SaveQuestionTime { get; set; }
 
 
+		/// <summary>
+		/// 不同意重阅原因
+		/// </summary>
+		public string DisagreeReason { get; set; } = string.Empty;
+
+
+		/// <summary>
+		/// 是否申请重阅
+		/// </summary>
+		public bool IsApplyHeavyReading { get; set; } = false;
+
+
 	}
 
 }