diff --git a/src/api/trials.js b/src/api/trials.js
index 10caf5d2..43eea227 100644
--- a/src/api/trials.js
+++ b/src/api/trials.js
@@ -3481,6 +3481,13 @@ export function getSplenicState(visitTaskId, spleenLength) {
     method: 'post'
   })
 }
+
+export function getSplenicVerify(visitTaskId) {
+  return request({
+    url: `/LuganoCalculate/getSplenicVerify?visitTaskId=${visitTaskId}`,
+    method: 'post'
+  })
+}
 export function uploadTrialSiteSurveyUser(trialId, baseUrl, routeUrl, param) {
   return request({
     url: `/TrialSiteSurvey/UploadTrialSiteSurveyUser?trialId=${trialId}&baseUrl=${baseUrl}&routeUrl=${routeUrl}`,
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/DicomCanvas.vue b/src/views/trials/trials-panel/reading/dicoms/components/DicomCanvas.vue
index a5877ce1..298bef3d 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/DicomCanvas.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/DicomCanvas.vue
@@ -867,7 +867,7 @@ export default {
     renderMeasuredData(e) {
       this.stack.frame = !isNaN(parseInt(this.stack.frame)) ? parseInt(this.stack.frame) : 0
       var idx = this.visitTaskList.findIndex(i => i.VisitTaskId === this.stack.visitTaskId)
-      if(idx === -1) return
+      if (idx === -1) return
       this.measureData = this.visitTaskList[idx].MeasureData
       const { element } = e.detail
       const ToolStateManager = cornerstoneTools.globalImageIdSpecificToolStateManager
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/PetCt.vue b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/PetCt.vue
index e92faee1..551786ee 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/PetCt.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/PetCt.vue
@@ -697,11 +697,11 @@ export default {
           this.onAnnotationModified(e)
         } else {
           // annotation.isInsideVolume = false
-          console.log('异常标记：',annotation)
+          console.log('异常标记：', annotation)
           const { remark } = annotation.data
           if (remark === 'Liver' || remark === 'Mediastinum') {
             this.$refs['questions'].setOutsideMeasuredData(annotation)
-          }else{
+          } else {
             this.$refs['tableQuestions'].setOutsideMeasuredData(annotation)
           }
           // // 移除标记
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestionItem.vue b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestionItem.vue
index 105880dd..444855bc 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestionItem.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestionItem.vue
@@ -257,7 +257,7 @@ export default {
       pictureBaseStr: '',
       currentMarkTool: '',
       firstRenderAnnotation: true,
-      isInsideVolume:true
+      isInsideVolume: true
     }
   },
   mounted() {
@@ -611,7 +611,7 @@ export default {
         resolve()
       })
     },
-    setOutsideMeasuredData(measureData){
+    setOutsideMeasuredData(measureData) {
       this.isInsideVolume = false
       var suvObj = this.questions.find(i => i.QuestionMark === 20)
       this.$set(this.questionForm, suvObj.Id, '')
@@ -621,20 +621,20 @@ export default {
         this.$set(this.questionForm, 'saveTypeEnum', 0)
       }
       this.$set(this.questionForm, 'OtherMeasureData', measureData)
-        var isLymph = this.getQuestionVal(2)
-        isLymph = !isNaN(parseInt(isLymph)) ? parseInt(isLymph) : null
-        const lesionPart = this.getQuestionVal(8)
-        const lesionOrgan = this.getQuestionVal(6)
-        var suvMax = this.getQuestionVal(20)
-        this.$emit('resetQuestions', { isLymphLesion: isLymph, lesionPart, lesionOrgan, suvMax, saveTypeEnum: this.questionForm.saveTypeEnum, rowIndex: this.rowIndex, questionId: this.parentQsId, anwsers: this.questionForm })
-        this.toolType = measureData.type
-        if (this.questionForm.MeasureData) {
-          this.organList = []
-          this.getOrganInfoList()
-        } else {
-          this.organList = []
-          this.getOrganInfoList()
-        }
+      var isLymph = this.getQuestionVal(2)
+      isLymph = !isNaN(parseInt(isLymph)) ? parseInt(isLymph) : null
+      const lesionPart = this.getQuestionVal(8)
+      const lesionOrgan = this.getQuestionVal(6)
+      var suvMax = this.getQuestionVal(20)
+      this.$emit('resetQuestions', { isLymphLesion: isLymph, lesionPart, lesionOrgan, suvMax, saveTypeEnum: this.questionForm.saveTypeEnum, rowIndex: this.rowIndex, questionId: this.parentQsId, anwsers: this.questionForm })
+      this.toolType = measureData.type
+      if (this.questionForm.MeasureData) {
+        this.organList = []
+        this.getOrganInfoList()
+      } else {
+        this.organList = []
+        this.getOrganInfoList()
+      }
     },
     returnFloat(num) {
       if (num) return
@@ -719,13 +719,13 @@ export default {
     handleSave() {
       this.$refs.measurementForm.validate(async valid => {
         if (!valid) return
-        if(!this.isInsideVolume){
+        if (!this.isInsideVolume) {
           this.$alert('当前标记在图像外，不允许保存！', '提示', {
             callback: action => {
               this.$message({
                 type: 'info',
-                message: `action: ${ action }`
-              });
+                message: `action: ${action}`
+              })
             }
           })
           return
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestions.vue b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestions.vue
index c90281b6..4889e51e 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestions.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/TableQuestions.vue
@@ -749,7 +749,7 @@ export default {
         this.$refs[refName][0].clearMeasurement()
       }
     },
-    setOutsideMeasuredData(annotation){
+    setOutsideMeasuredData(annotation) {
       if (this.activeItem.activeCollapseId && this.activeItem.activeRowIndex && this.activeName) {
         const refName = `${this.activeItem.activeCollapseId}_${this.activeItem.activeRowIndex}`
         this.$refs[refName][0].setOutsideMeasuredData(annotation)
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue b/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
index bfdf6367..3af9cd53 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
@@ -33,7 +33,7 @@
 
 <script>
 // import { uploadPrintscreen } from '@/api/reading'
-import { saveImageQuality, getSplenicState } from '@/api/trials'
+import { saveImageQuality, getSplenicState,getSplenicVerify } from '@/api/trials'
 import QuestionItem from './QuestionItem'
 import DicomEvent from './DicomEvent'
 import { mapGetters } from 'vuex'
@@ -77,7 +77,9 @@ export default {
       spleenStatusId: '',
       spleenLengthId: '',
       isBaseLineTask: false,
-      criterionType: null
+      criterionType: null,
+      spleenInfo:null,
+      calculateSpleenStatus:''
     }
   },
   computed: {
@@ -91,6 +93,14 @@ export default {
         if(this.isQulityIssues){
           DicomEvent.$emit('questionFormChange', true)
         }
+        // if(this.criterionType === 2 && this.groupClassify === 3 && this.calculateSpleenStatus && this.calculateSpleenStatus !== this.questionForm[this.spleenStatusId]){
+        //   for (let i = 0; i < this.questions[0].Childrens.length; i++) {
+        //     if (this.questions[0].Childrens[i].QuestionType === 49) {
+        //       this.questions[0].Childrens[i].ShowQuestion = 2
+        //       break
+        //     }
+        //   }
+        // }
       }
     },
     currentReadingTaskState: {
@@ -132,7 +142,12 @@ export default {
             }
             this.measurements.push(i)
           })
+          if(this.readingTaskState < 2 && !this.isBaseLineTask && !this.spleenInfo){
+            const { Result } =  await getSplenicVerify(visitTaskId)
+            this.spleenInfo = Result
+          }
         }
+       
         for (var i = 0; i < questions.length; i++) {
           var v = questions[i]
           v.IsBaseLineTask = this.isBaseLineTask
@@ -151,6 +166,8 @@ export default {
             if (v.QuestionType === 48) {
               // 脾脏长度
               this.spleenLengthId = v.Id
+              this.calculateSpleenStatus = ''
+              this.setSpleenStatus(this.questionForm[this.spleenLengthId])
             }
           }
           if (v.Childrens.length > 0) {
@@ -192,33 +209,22 @@ export default {
         if (!valid) return
         // lugano标准校验脾脏状态是否符合要求
         if (this.criterionType === 2 && this.groupClassify === 3) {
-          var res = await this.getSplenicState()
-          if (res.isSuccess) {
-            var systemSpleenStatus = isNaN(parseInt(res.result)) ? null : parseInt(res.result)
-            var currentSpleenStatus = this.questionForm[this.spleenStatusId]
-            var currentSpleenLength = this.questionForm[this.spleenLengthId]
-            currentSpleenStatus = isNaN(parseInt(currentSpleenStatus)) ? null : parseInt(currentSpleenStatus)
-            if (currentSpleenLength && currentSpleenStatus === 5) {
-              // '脾脏状态为不可评估，不需要添加标记!'
-              this.$alert(this.$t('trials:lugano:message:validSpleen1'), this.$t('trials:lugano:fusionDialog:warning'), {
+          var currentSpleenStatus = this.questionForm[this.spleenStatusId]
+          var currentSpleenLength = this.questionForm[this.spleenLengthId]
+          currentSpleenStatus = isNaN(parseInt(currentSpleenStatus)) ? null : parseInt(currentSpleenStatus)
+          var idx = this.measurements.findIndex(i => i.QuestionType === 48)
+          if (currentSpleenLength && currentSpleenStatus === 5) {
+            // '脾脏状态为不可评估，不需要添加标记!'
+            this.$alert(this.$t('trials:lugano:message:validSpleen1'), this.$t('trials:lugano:fusionDialog:warning'), {
                 callback: _ => {}
               })
-            } else {
-              if (systemSpleenStatus !== currentSpleenStatus) {
-                // 系统自动计算的脾脏状态为：xxx，当前设置的脾脏状态为：yyy，是否继续保存？
-                var message = this.$t('trials:lugano:message:validSpleen2').replace('xxx', this.$fd('SpleenState', systemSpleenStatus))
-                message = message.replace('yyy', this.$fd('SpleenState', currentSpleenStatus))
-                this.$confirm(message, this.$t('trials:lugano:fusionDialog:warning'), {
-                  type: 'warning'
-                }).then(() => {
-                  this.saveQuestionsList()
-                }).catch(() => {
-
-                })
-              } else {
-                this.saveQuestionsList()
-              }
-            }
+          }else if(currentSpleenLength === 5 && idx> -1 && this.measurements[idx].MeasureData){
+            // 若有标记，状态不可为“无法评估”
+            this.$alert(this.$t('trials:lugano:message:validSpleen1'), this.$t('trials:lugano:fusionDialog:warning'), {
+                callback: _ => {}
+              })
+          }else{
+            this.saveQuestionsList()
           }
         } else {
           this.saveQuestionsList()
@@ -297,7 +303,7 @@ export default {
       }
     },
     // 上传截图
-    async  uploadScreenshot() {
+    async uploadScreenshot() {
       for (let i = 0; i < this.measurements.length; i++) {
         if (this.measurements[i].pictureBaseStr) {
           var pictureObj = await this.uploadScreenshots(`${new Date().getTime()}`, this.measurements[i].pictureBaseStr)
@@ -364,6 +370,9 @@ export default {
       var idx = this.measurements.findIndex(i => i.QuestionId === Id)
       if (idx === -1) return
       this.$set(this.questionForm, Id, '')
+      if (this.measurements[idx].QuestionType === 48){
+        this.$set(this.questionForm, this.spleenStatusId, '')
+      }
       await store.dispatch('reading/removeNonTargetMeasuredData', { visitTaskId: this.visitTaskId, measureData: this.measurements[idx].MeasureData, questionId: Id })
       this.measurements.splice(idx, 1)
       DicomEvent.$emit('getMeasureData')
@@ -414,20 +423,85 @@ export default {
       if (measurement.type === 'Length') {
         const length = measurement.data.length ? measurement.data.length : null
         this.$set(this.questionForm, this.measurements[idx].QuestionId, length || null)
-        if (this.measurements[idx].QuestionType === 48 && length <= 130 && this.isBaseLineTask) {
-          // 脾脏状态设置默认值为正常
-          this.$set(this.questionForm, this.spleenStatusId, '1')
-        }
-        if (this.measurements[idx].QuestionType === 48 && length > 130 && this.isBaseLineTask) {
-          // 脾脏状态设置默认值为肿大
-          this.$set(this.questionForm, this.spleenStatusId, '6')
+        if (this.measurements[idx].QuestionType === 48){
+          this.calculateSpleenStatus = ''
+          this.setSpleenStatus(length)
         }
+        
+        // if (this.measurements[idx].QuestionType === 48 && length <= 130 && this.isBaseLineTask) {
+        //   // 脾脏状态设置默认值为正常
+        //   this.$set(this.questionForm, this.spleenStatusId, '1')
+        // }
+        // if (this.measurements[idx].QuestionType === 48 && length > 130 && this.isBaseLineTask) {
+        //   // 脾脏状态设置默认值为肿大
+        //   this.$set(this.questionForm, this.spleenStatusId, '6')
+        // }
       }
       store.dispatch('reading/addOrUpdateNonTargetMeasuredData', { visitTaskId: this.visitTaskId, data: data })
       if(this.isQulityIssues){
         DicomEvent.$emit('questionFormChange', true)
       }
     },
+    setSpleenStatus(length){
+      if(length){
+        if(this.isBaseLineTask){
+          // 直径≤130mm时，系统默认脾脏状态为“正常”
+          if(length <= 130){
+            this.$set(this.questionForm, this.spleenStatusId, '1')
+            this.calculateSpleenStatus = '1'
+          }
+          // 直径>130mm时，系统默认脾脏状态为“肿大”
+          if(length > 130){
+            this.$set(this.questionForm, this.spleenStatusId, '6')
+            this.calculateSpleenStatus = '6'
+          }
+        }else{
+          // 与基线相比脾垂直径变化值
+          var diffFromBaseline = length - this.spleenInfo.BaseLineSpleenLength
+          var percentFormBaseline = 0
+          if(this.spleenInfo.BaseLineSpleenLength){
+            percentFormBaseline = length * 100 / (this.spleenInfo.BaseLineSpleenLength - 130)
+          }
+          if(this.spleenInfo.BaseLineSpleenLength > 130 && diffFromBaseline >= 10 && percentFormBaseline > 50){
+            // 1、基线 垂直径>130 mm
+            // 2、与基线相比脾垂直径变化值≥10 mm
+            // 3、与基线相比脾肿大增加的百分比>50％
+            // 系统默认脾脏状态为“显著增大”
+            this.$set(this.questionForm, this.spleenStatusId, '4')
+            this.calculateSpleenStatus = '4'
+          }else if( this.spleenInfo.BaseLineSpleenLength <= 130 && diffFromBaseline >= 20 && length > 130){
+            // 1、基线垂直径≤130mm
+            // 2、与基线相比脾垂直径变化值≥20 mm
+            // 3、当前垂直径>130 mm
+            // 系统默认脾脏状态为“显著增大”
+            this.$set(this.questionForm, this.spleenStatusId, '4')
+            this.calculateSpleenStatus = '4'
+          }else if( this.spleenInfo.BaseLineSpleenLength > 130 && this.spleenInfo.LowSpleenLength <= 130 && diffFromBaseline >= 20 && length > 130){
+            // 1、基线 垂直径>130 mm
+            // 2、当前访视的前面访视中 存在垂直径≤130mm
+            // 3、与最低点相比脾脏垂直径的增加值≥20 mm
+            // 4、当前垂直径>130 mm
+            // 系统默认脾脏状态为“显著增大”
+            this.$set(this.questionForm, this.spleenStatusId, '4')
+            this.calculateSpleenStatus = '4'
+          }else if(length < 130){
+            // 当前访视的垂直径≤130mm
+            // 系统默认脾脏状态为“正常”
+            this.$set(this.questionForm, this.spleenStatusId, '1')
+            this.calculateSpleenStatus = '1'
+          }else if(this.spleenInfo.BaseLineState === '6' && percentFormBaseline < -50){
+            // 1、基线期 状态为“肿大”
+            // 2、与基线相比脾肿大增加的百分比小于-50％
+            // 系统默认脾脏状态为“部分缓解”
+            this.$set(this.questionForm, this.spleenStatusId, '2')
+            this.calculateSpleenStatus = '2'
+          }else{
+            this.$set(this.questionForm, this.spleenStatusId, '3')
+            this.calculateSpleenStatus = '3'
+          }
+        }
+      }
+    },
     resetFormItemData(v) {
       this.questionForm[v] = null
       if (v === this.spleenLengthId) {