diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
index 3835792cd..c4864d213 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
@@ -92,6 +92,8 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
     {
         public Guid? QuestionId { get; set; }
 
+        public bool IsHaveChange { get; set; } = false;
+
         public string QuestionName { get; set; }
 
         public string Answer { get; set; }
@@ -357,8 +359,9 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
 
         public string QuestionName { get; set; }
 
-        public string Answer { get; set; }
+        public dynamic Answer { get; set; }
 
+        public JudgeReadingQuestionType QuestionType { get; set; } = JudgeReadingQuestionType.Question;
 
     }
 
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingImageTaskService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingImageTaskService.cs
index aceeab303..bd98b44ff 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingImageTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingImageTaskService.cs
@@ -209,6 +209,7 @@ namespace IRaCIS.Application.Services
                       (lr.global.Select(x => x.Answer).FirstOrDefault().IsNullOrEmpty()&& inDto.UsingOriginalData?
                       lr.question.Answer:lr.global.Select(x => x.Answer).FirstOrDefault()
                       ),
+                      IsHaveChange= lr.global==null? false: lr.global.Any(),
                       QuestionId = lr.question.QuestionId,
                       QuestionName = lr.question.QuestionName,
                       Type = lr.question.Type,
@@ -801,7 +802,7 @@ namespace IRaCIS.Application.Services
                             VisitTaskInfoList = new List<JudgeReadingQuestion>(),
                         };
 
-                        judgeReadingInfo.VisitTaskInfoList.Add(new JudgeReadingQuestion()
+                        var judgeReadingQuestion = new JudgeReadingQuestion()
                         {
                             ArmEnum = item.ArmEnum,
                             VisitTaskId = item.VisitTaskId,
@@ -812,10 +813,28 @@ namespace IRaCIS.Application.Services
                                 QuestionId = x.QuestionId.Value,
                                 QuestionName = x.QuestionName
                             }).ToList()
+                        };
+
+
+
+                        // 加全局是否更新 和访视点注释
+                        judgeReadingQuestion.JudgeQuestionList.Add( new JudgeQuestion() { 
+                         Answer= item.AfterQuestionList.Any(x=>x.IsHaveChange),
+                         QuestionType= JudgeReadingQuestionType.GlobalChange,
+
                         });
+
+                        judgeReadingQuestion.JudgeQuestionList.Add(new JudgeQuestion()
+                        {
+                            Answer = item.AfterQuestionList.Where(x => x.QuestionId==null).Select(x=>x.Answer).FirstOrDefault(),
+                            QuestionType = JudgeReadingQuestionType.VisitRemark,
+
+                        });
+
+                        judgeReadingInfo.VisitTaskInfoList.Add(judgeReadingQuestion);
                         if (twoItem != null)
                         {
-                            judgeReadingInfo.VisitTaskInfoList.Add(new JudgeReadingQuestion()
+                           var rTwoJudge = new JudgeReadingQuestion()
                             {
                                 ArmEnum = twoItem.ArmEnum,
                                 VisitTaskId = twoItem.VisitTaskId,
@@ -826,7 +845,24 @@ namespace IRaCIS.Application.Services
                                     QuestionId = x.QuestionId.Value,
                                     QuestionName = x.QuestionName
                                 }).ToList()
+                            };
+
+                            // 加全局是否更新 和访视点注释
+                            judgeReadingQuestion.JudgeQuestionList.Add(new JudgeQuestion()
+                            {
+                                Answer = twoItem.AfterQuestionList.Any(x => x.IsHaveChange),
+                                QuestionType = JudgeReadingQuestionType.GlobalChange,
+
                             });
+
+                            judgeReadingQuestion.JudgeQuestionList.Add(new JudgeQuestion()
+                            {
+                                Answer = twoItem.AfterQuestionList.Where(x => x.QuestionId == null).Select(x => x.Answer).FirstOrDefault(),
+                                QuestionType = JudgeReadingQuestionType.VisitRemark,
+
+                            });
+
+                            judgeReadingInfo.VisitTaskInfoList.Add(rTwoJudge);
                         }
 
                         judgeInfo.VisitInfoList.Add(judgeReadingInfo);
diff --git a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
index b4120536a..ec882e92f 100644
--- a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
+++ b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
@@ -179,6 +179,27 @@ namespace IRaCIS.Core.Domain.Share
         Read = 2,
     }
 
+    /// <summary>
+    /// 裁判阅片问题类型
+    /// </summary>
+    public enum JudgeReadingQuestionType
+    {
+        /// <summary>
+        /// 问题
+        /// </summary>
+        Question=1,
+
+        /// <summary>
+        /// 全局修改
+        /// </summary>
+        GlobalChange=2,
+
+        /// <summary>
+        /// 访视点注释
+        /// </summary>
+        VisitRemark = 3,
+    }
+
     public enum JudgeTypeEnum
     {
         None=0,