diff --git a/IRaCIS.Core.Application/Service/ImageAndDoc/DownloadAndUploadService.cs b/IRaCIS.Core.Application/Service/ImageAndDoc/DownloadAndUploadService.cs
index 900e69687..df5080e40 100644
--- a/IRaCIS.Core.Application/Service/ImageAndDoc/DownloadAndUploadService.cs
+++ b/IRaCIS.Core.Application/Service/ImageAndDoc/DownloadAndUploadService.cs
@@ -11,6 +11,7 @@ using IRaCIS.Core.Domain.Models;
 using IRaCIS.Core.Domain.Share;
 using IRaCIS.Core.Infra.EFCore.Common;
 using IRaCIS.Core.Infrastructure;
+using IRaCIS.Core.Infrastructure.Extention;
 using MassTransit;
 using MassTransit.Initializers;
 using MathNet.Numerics;
@@ -935,14 +936,19 @@ namespace IRaCIS.Core.Application.Service.ImageAndDoc
             //靶段标注上传，查看访视级别，上传绑定访视级别
             if (inQuery.IsImageSegmentLabel == true)
             {
+
+                var noneDicomSVList = await _noneDicomStudyReposiotry.Where(t => t.SubjectId == inQuery.SubjectId && t.Modality == "IVUS")
+                    .Select(t => t.SubjectVisitId).Distinct().ToListAsync();
                 //存在ivus 和oct 这两种的项目
                 if (_readingQuestionCriterionTrialRepository.Where(t => t.TrialId == info.TrialId &&
                 (t.CriterionType == CriterionType.IVUS || t.CriterionType == CriterionType.OCT)).Distinct().Count() == 2
-                && !_noneDicomStudyReposiotry.Any(t => t.SubjectId == inQuery.SubjectId && t.Modality == "IVUS"))
+                && noneDicomSVList.Count() !=
+                 _dicomStudyRepository.Where(t => t.SubjectId == inQuery.SubjectId).Select(t => t.SubjectVisitId).Distinct().Count())
                 {
                     #region ivus 自动创建非dicom检查
 
                     var addList = await _dicomStudyRepository.Where(t => t.SubjectId == inQuery.SubjectId)
+                           .Where(t => !noneDicomSVList.Contains(t.SubjectVisitId))
                            .Select(t => new NoneDicomStudyAddOrEdit()
                            {
                                TrialId = t.TrialId,