diff --git a/src/api/reading.js b/src/api/reading.js
index 7a672889..fc50fe40 100644
--- a/src/api/reading.js
+++ b/src/api/reading.js
@@ -294,3 +294,12 @@ export function readingImport(param) {
     data: param
   })
 }
+
+// 非dicom阅片保存标记
+export function saveAnswerAndBindingNoneDicomMark(param) {
+  return request({
+    url: `/ReadingImageTask/saveAnswerAndBindingNoneDicomMark`,
+    method: 'post',
+    data: param
+  })
+}
diff --git a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionList.vue b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionList.vue
index 8c4ac9f0..cd3db621 100644
--- a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionList.vue
+++ b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionList.vue
@@ -56,7 +56,7 @@
 <script>
 
 import { getCustomTableQuestionAnswer, changeDicomReadingQuestionAnswer, submitVisitTaskQuestionsInDto, verifyVisitTaskQuestions, getQuestionCalculateRelation, saveTaskQuestion } from '@/api/trials'
-import { setSkipReadingCache, resetReadingTask, saveTableQuestionMark } from '@/api/reading'
+import { setSkipReadingCache, resetReadingTask, saveTableQuestionMark, saveAnswerAndBindingNoneDicomMark } from '@/api/reading'
 import const_ from '@/const/sign-code'
 import QuestionFormItem from './QuestionFormItem'
 import SignForm from '@/views/trials/components/newSignForm'
@@ -76,6 +76,10 @@ export default {
     readingTaskState: {
       type: Number,
       required: true
+    },
+    isNoneDicom: {
+      type: Boolean,
+      default: false
     }
   },
   data() {
@@ -127,7 +131,8 @@ export default {
       this.loading = true
       try {
         const param = {
-          visitTaskId: this.visitTaskId
+          visitTaskId: this.visitTaskId,
+          IsDicomReading: !this.isNoneDicom
         }
         const res = await getCustomTableQuestionAnswer(param)
         if (res.IsSuccess) {
@@ -154,7 +159,11 @@ export default {
             }
           })
           this.questions = res.Result.SinglePage
+          if (this.isNoneDicom) {
+            this.$emit("setIsHaveBindingQuestion", res.OtherInfo.IsHaveBindingQuestion)
+          }
           this.questionsMarkStatus = {}
+          this.questionMarkInfoList = []
           this.questionMarkInfoList = res.OtherInfo.QuestionMarkInfoList.map(i => {
             if (i.RowId) {
               this.$set(this.questionsMarkStatus, `${i.RowId}_${i.TableQuestionId}`, { isMarked: i.MeasureData !== '', isSaved: true, OrderMarkName: i.OrderMarkName })
@@ -353,162 +362,6 @@ export default {
       const i = this.questionMarkInfoList.findIndex(i => i.MeasureData && i.MeasureData.annotationUID === annotation.annotationUID)
       return i > -1
     },
-    // async operateImageMarker(obj) {
-    //   this.operateStateEnum = obj.operateStateEnum
-    //   this.isTableQuestion = obj.question.IsTableQuestion ? true : false
-    //   this.imageTool = obj.question.ImageTool
-    //   this.imageToolAttribute = obj.question.ImageToolAttribute
-    //   this.operateQuestionId = obj.question.Id
-    //   this.operateRowId = obj.question.RowId
-    //   this.operateParentQsId = obj.question.ParentQsId
-    //   if (obj.operateStateEnum === 0) { 
-    //     // 绑定标记
-    //     this.$emit('setReadingToolPassive')
-    //   } else if (obj.operateStateEnum === 1) {
-    //     // 添加标记
-    //     this.$emit('setReadingToolActive', obj.question.ImageTool)
-    //   } else if (obj.operateStateEnum === 2) {
-    //     // 查看标记
-    //     let i = -1
-    //     if (this.isTableQuestion) {
-    //       if (this.operateRowId) {
-    //         i = this.questionMarkInfoList.findIndex(i => i.TableQuestionId === obj.question.Id && i.RowId === this.operateRowId)
-    //       } else {
-    //         i = this.questionMarkInfoList.findIndex(i => i.TableQuestionId === obj.question.Id && !i.RowId)
-    //       }
-    //     } else {
-    //       i = this.questionMarkInfoList.findIndex(i => i.QuestionId === obj.question.Id)
-    //     }
-    //     if (i > -1) {
-    //       const annotation = this.questionMarkInfoList[i].MeasureData
-    //       this.$emit('viewCustomAnnotationSeries', { visitTaskId: this.visitTaskId, annotation })
-    //     }
-    //   } else if (obj.operateStateEnum === 3) {
-    //     // 更改标记
-    //     this.$emit('setReadingToolPassive')
-    //   } else if (obj.operateStateEnum === 4) {
-    //     this.$emit('setReadingToolPassive')
-    //     // 移除标记
-    //     let i = -1
-    //     let questionMarkInfo = {}
-    //     if (this.isTableQuestion) {
-    //       if (this.operateRowId) {
-    //         i = this.questionMarkInfoList.findIndex(i => i.TableQuestionId === obj.question.Id && i.RowId === this.operateRowId)
-    //       } else {
-    //         i = this.questionMarkInfoList.findIndex(i => i.TableQuestionId === obj.question.Id && !i.RowId)
-    //       }
-    //     } else {
-    //       this.$set(this.questionForm, obj.question.Id, '')
-    //       i = this.questionMarkInfoList.findIndex(i => i.QuestionId === obj.question.Id)
-    //     }
-    //     if (i === -1) return
-    //     this.questionMarkInfoList[i].MeasureData = ''
-    //     this.questionMarkInfoList[i].StudyId = ''
-    //     this.questionMarkInfoList[i].SeriesId = ''
-    //     this.questionMarkInfoList[i].InstanceId = ''
-    //     questionMarkInfo = this.questionMarkInfoList[i]
-    //     questionMarkInfo.isMarked = false
-    //     questionMarkInfo.isSaved = false
-    //     this.$set(this.questionsMarkStatus, this.operateRowId ? `${this.operateRowId}_${obj.question.Id}` : obj.question.Id, questionMarkInfo)
-    //   } else if (obj.operateStateEnum === 5) {
-    //     // 保存外层标记
-    //     this.loading = true
-    //     try {
-    //       const answers = []
-    //       answers.push({ id: obj.question.Id, answer: this.questionForm[obj.question.Id] })
-    //       const markInfo = []
-    //       const i = this.questionMarkInfoList.findIndex(i => i.QuestionId === this.operateQuestionId)
-    //       if (i > -1) {
-    //         const obj = Object.assign({}, this.questionMarkInfoList[i])
-    //         obj.MeasureData = obj.MeasureData ? JSON.stringify(obj.MeasureData) : ''
-    //         markInfo.push(obj)
-    //       }
-    //       // 上传截图
-    //       const params = {
-    //         visitTaskId: this.visitTaskId,
-    //         answers: answers,
-    //         questionMarkInfoList: markInfo
-    //       }
-    //       await saveTaskQuestion(-10, params)
-
-    //       this.$set(this.questionsMarkStatus, obj.question.Id, {isMarked: this.questionMarkInfoList[i].MeasureData ? true : false, isSaved: true})
-    //       this.loading = false
-    //     } catch (e) {
-    //       console.log(e)
-    //       this.loading = false
-    //     }
-    //   } else if (obj.operateStateEnum === 6) {
-    //     // 更改数值内容
-    //     let questionMarkInfo = {}
-    //     if (this.isTableQuestion) {
-    //       questionMarkInfo.isMarked = false
-    //       questionMarkInfo.isSaved = false
-    //     } else {
-    //       questionMarkInfo.isMarked = false
-    //       questionMarkInfo.isSaved = false
-    //     }
-    //     this.$set(this.questionsMarkStatus, this.operateRowId ? `${this.operateRowId}_obj.question.Id` : obj.question.Id, questionMarkInfo)
-    //   } else if (obj.operateStateEnum === 7) {
-    //     // 保存表格问题标记
-    //     const loading = this.$loading({ fullscreen: true })
-    //     try {
-    //       let annotation = null
-    //       if (!this.operateRowId && obj.rowId && obj.question.ParentQsId) {
-    //         this.operateRowId = obj.rowId
-    //         this.questionMarkInfoList.forEach(item => {
-    //           if (item.QuestionId === obj.question.ParentQsId && !item.RowId) {
-    //             item.RowId = obj.rowId
-    //             let questionMarkStatus = Object.assign({}, this.questionsMarkStatus[item.TableQuestionId])
-    //             delete this.questionsMarkStatus[item.TableQuestionId]
-    //             if (item.TableQuestionId === this.operateQuestionId) {
-    //               annotation = item.MeasureData
-    //               this.$set(this.questionsMarkStatus, `${obj.rowId}_${item.TableQuestionId}`, questionMarkStatus)
-    //             } else {
-    //               this.$set(this.questionsMarkStatus, `${obj.rowId}_${item.TableQuestionId}`, {isMarked: item.MeasureData ? true : false, isSaved: false})
-    //             }
-
-    //           }
-    //         })
-    //       } else if (this.operateRowId && this.operateQuestionId) {
-    //         const i = this.questionMarkInfoList.findIndex(i => i.RowId === this.operateRowId && i.TableQuestionId === this.operateQuestionId)
-    //         if (i === -1) return
-    //         annotation = this.questionMarkInfoList[i].MeasureData
-    //       }
-    //       let picturePath = ''
-    //       if (annotation) {
-    //         // 上传截图
-    //         const base64Str = await this.getScreenshots({ visitTaskId: this.visitTaskId, annotation })
-    //         const pictureObj = await this.uploadScreenshots(`${new Date().getTime()}`, base64Str)
-    //         picturePath = pictureObj.isSuccess ? this.$getObjectName(pictureObj.result.url) : ''
-    //       }
-    //       let params = {
-    //         Answer: obj.answer,
-    //         VisitTaskId: this.visitTaskId,
-    //         QuestionId: obj.question.ParentQsId,
-    //         InstanceId: annotation ? annotation.instanceId : '',
-    //         SeriesId: annotation ? annotation.seriesId : '',
-    //         StudyId: annotation ? annotation.studyId : '',
-    //         MarkTool: annotation ? annotation.markTool : '',
-    //         PicturePath: picturePath,
-    //         NumberOfFrames: annotation ? annotation.numberOfFrames : null,
-    //         MeasureData: annotation ? JSON.stringify(annotation) : '',
-    //         QuestionType: 0,
-    //         OrderMarkName: annotation ? annotation.data.label : '',
-    //         RowId: this.operateRowId,
-    //         TableQuestionId: this.operateQuestionId,
-    //         RowIndex: obj.rowIndex
-    //       }
-    //       // 保存标记
-    //       await saveTableQuestionMark(params, -10)
-    //       this.$set(this.questionsMarkStatus, `${this.operateRowId}_${this.operateQuestionId}`, {isMarked: annotation ? true : false, isSaved: true})
-    //       this.resetOperateState()
-    //       loading.close()
-    //     } catch(e) {
-    //       console.log(e)
-    //       loading.close()
-    //     }
-    //   }
-    // },
     async operateImageMarker(obj) {
       const STATE = {
         BIND: 0,       // 绑定标记
@@ -538,9 +391,9 @@ export default {
         [STATE.VIEW]: this.handleViewAnnotation,
         [STATE.CHANGE]: () => this.$emit('setReadingToolPassive'),
         [STATE.REMOVE]: this.handleRemoveAnnotation,
-        [STATE.SAVE_OUTER]: this.handleSaveOuterQuestions,
+        [STATE.SAVE_OUTER]: this.isNoneDicom ? this.handleSaveNoneDicomOuterQuestions : this.handleSaveOuterQuestions,
         [STATE.UPDATE]: this.handleUpdateValue,
-        [STATE.SAVE_TABLE]: this.handleSaveTableQuestions
+        [STATE.SAVE_TABLE]: this.isNoneDicom ? this.handleSaveNoneDicomTableQuestions : this.handleSaveTableQuestions
       }
 
       const handler = stateHandlers[operateStateEnum]
@@ -574,6 +427,73 @@ export default {
         isSaved: false,
       })
     },
+    async handleSaveNoneDicomOuterQuestions(obj) {
+      this.loading = true;
+      try {
+        const answers = [{ QuestionId: obj.question.Id, answer: this.questionForm[obj.question.Id] }]
+        const markInfo = []
+        const index = this.questionMarkInfoList.findIndex(
+          item => item.QuestionId === this.operateQuestionId
+        )
+
+        if (index > -1) {
+          const item = { ...this.questionMarkInfoList[index] }
+          item.MeasureData = item.MeasureData ? JSON.stringify(item.MeasureData) : ''
+          markInfo.push(item)
+          markInfo[0].PicturePath = ''
+        }
+        let annotation = null
+        if (!this.operateRowId && obj.rowId) {
+          this.operateRowId = obj.rowId
+          // this.updateQuestionsMarkStatus(obj)
+        }
+        annotation = this.getAnnotationByRow(obj.question.Id, false)
+        // 截图上传
+        let picturePath = obj.picturePath
+        if (annotation) {
+          const base64Str = await this.getScreenshots({
+            visitTaskId: this.visitTaskId,
+            annotation
+          })
+          if (!picturePath) {
+            const pictureObj = await this.uploadScreenshots(`${Date.now()}`, base64Str)
+            picturePath = pictureObj.isSuccess ? this.$getObjectName(pictureObj.result.url) : ''
+          }
+          markInfo[0].PicturePath = picturePath
+        }
+        if (markInfo && markInfo.length > 0) {
+          markInfo[0].MarkId = annotation ? annotation.annotationUID : null
+        }
+        await saveAnswerAndBindingNoneDicomMark({
+          visitTaskId: this.visitTaskId,
+          StudyId: annotation.studyId,
+          NoneDicomFileId: annotation.noneDicomFileId,
+          ...answers[0],
+          ...markInfo[0]
+        })
+        this.loading = false
+        this.$set(this.questionsMarkStatus, obj.question.Id, {
+          isMarked: !!this.questionMarkInfoList[index]?.MeasureData,
+          isSaved: true,
+          OrderMarkName: index > -1 ? this.questionMarkInfoList[index].OrderMarkName : ''
+        })
+        this.resetOperateState()
+        if (annotation) {
+          for (let i = 0; i < this.questionMarkInfoList.length; i++) {
+            const item = this.questionMarkInfoList[i]
+            if (!item.MeasureData || item.MeasureData.annotationUID !== annotation.annotationUID) continue
+            const isTableMode = item.TableQuestionId
+            if (!isTableMode && this.questionsMarkStatus[item.QuestionId] && !this.questionsMarkStatus[item.QuestionId].isSaved && this.questionsMarkStatus[item.QuestionId].isMarked) {
+              DicomEvent.$emit('operateImageMarker', { QuestionId: item.QuestionId, operateStateEnum: 5, picturePath })
+              break
+            }
+          }
+        }
+      } catch (err) {
+        console.log(err)
+        this.loading = false
+      }
+    },
     async handleSaveOuterQuestions(obj) {
       this.loading = true;
       try {
@@ -647,6 +567,65 @@ export default {
         isSaved: false,
       })
     },
+    async handleSaveNoneDicomTableQuestions(obj) {
+      const loading = this.$loading({ fullscreen: true })
+      try {
+        let annotation = null
+        if (!this.operateRowId && obj.rowId && obj.question.ParentQsId) {
+          this.operateRowId = obj.rowId
+          this.updateQuestionsMarkStatus(obj)
+        }
+        annotation = this.getAnnotationByRow(this.operateRowId)
+        // 截图上传
+        let picturePath = obj.picturePath
+        if (annotation && !picturePath) {
+          const base64Str = await this.getScreenshots({
+            visitTaskId: this.visitTaskId,
+            annotation
+          })
+          const pictureObj = await this.uploadScreenshots(`${Date.now()}`, base64Str)
+          picturePath = pictureObj.isSuccess ? this.$getObjectName(pictureObj.result.url) : ''
+        }
+        await saveAnswerAndBindingNoneDicomMark({
+          Answer: obj.answer,
+          VisitTaskId: this.visitTaskId,
+          QuestionId: obj.question.ParentQsId,
+          ...(annotation ? {
+            StudyId: annotation.studyId,
+            MarkTool: annotation.markTool,
+            MeasureData: JSON.stringify(annotation),
+            OrderMarkName: annotation.data.label,
+            NoneDicomFileId: annotation.noneDicomFileId,
+          } : {}),
+          Path: picturePath ? picturePath : '',
+          QuestionType: 0,
+          RowId: this.operateRowId,
+          TableQuestionId: this.operateQuestionId,
+          RowIndex: obj.rowIndex,
+          MarkId: annotation ? annotation.annotationUID : null
+        })
+        this.$set(this.questionsMarkStatus,
+          `${this.operateRowId}_${this.operateQuestionId}`,
+          { isMarked: !!annotation, isSaved: true, OrderMarkName: annotation ? annotation.data.label : '' }
+        )
+        this.resetOperateState()
+        if (annotation) {
+          for (let i = 0; i < this.questionMarkInfoList.length; i++) {
+            const item = this.questionMarkInfoList[i]
+            if (!item.MeasureData || item.MeasureData.annotationUID !== annotation.annotationUID) continue
+            const isTableMode = item.TableQuestionId
+            if (isTableMode && ((this.questionsMarkStatus[`${item.RowId}_${item.TableQuestionId}`] && !this.questionsMarkStatus[`${item.RowId}_${item.TableQuestionId}`].isSaved && this.questionsMarkStatus[`${item.RowId}_${item.TableQuestionId}`].isMarked) || (this.questionsMarkStatus[`${item.TableQuestionId}`] && !this.questionsMarkStatus[`${item.TableQuestionId}`].isSaved && this.questionsMarkStatus[`${item.TableQuestionId}`].isMarked))) {
+              DicomEvent.$emit('operateImageMarkerTable', { QuestionId: item.TableQuestionId, operateStateEnum: 7, picturePath })
+              break
+            }
+          }
+        }
+      } catch (e) {
+        console.error('表格保存失败:', e)
+      } finally {
+        loading.close()
+      }
+    },
     async handleSaveTableQuestions(obj) {
       const loading = this.$loading({ fullscreen: true })
       try {
@@ -772,7 +751,6 @@ export default {
               && item.RowId !== this.operateRowId && item.RowId
           )
           // && this.operateRowId
-          console.log(conflictIndex)
           if (conflictIndex > -1) {
             //该标记已绑定到其他行，不能更改绑定！
             this.$alert(this.$t("dicom3D:CustomizeQuestionList:alert:markIsbind"))
@@ -808,6 +786,7 @@ export default {
             StudyId: annotation.studyId,
             MarkTool: annotation.metadata.toolName,
             PicturePath: '',
+            Path: annotation.path,
             NumberOfFrames: annotation.numberOfFrames,
             MeasureData: annotation,
             RowId: this.operateRowId || '',
@@ -956,11 +935,33 @@ export default {
       const hasProp = cachedStats
         && Object.prototype.hasOwnProperty.call(cachedStats, prop)
       if (!hasProp) return null
-      const value = cachedStats[prop]
+      let value = cachedStats[prop]
+      if (this.isNoneDicom && annotation.ps) {
+        let ps = annotation.ps
+        if (prop === 'area') value = this.reRound(value * ps * ps, this.digitPlaces)
+        if (prop === 'length' || prop === 'perimeter') value = this.reRound(value * ps, this.digitPlaces)
+      }
       return value !== null
         ? parseFloat(value).toFixed(this.digitPlaces)
         : value
     },
+    reRound(result, finalPrecision) {
+      if (typeof result === 'string' && result.includes(', ')) {
+        const numStrs = result.split(', ')
+        const processed = numStrs.map(str => this.processSingle(str, finalPrecision))
+        return processed.join(', ')
+      }
+      return this.processSingle(result, finalPrecision)
+    },
+    processSingle(str, precision) {
+      const num = parseFloat(str)
+      if (isNaN(num)) return 'NaN'
+
+      // 保留原极小值处理逻辑
+      if (Math.abs(num) < 0.0001) return str
+      const factor = 10 ** precision
+      return (Math.round(num * factor + 0.0000001) / factor).toFixed(precision)
+    },
     unBindAnnotationToQuestion(obj) {
       const { markTableQuestions = [], questionId } = obj || {}
       const { questionMarkInfoList, questionsMarkStatus } = this
@@ -1123,6 +1124,26 @@ export default {
         // this.setMeasuredData(event.data.data)
       }
     }
+  },
+  watch: {
+    questionsMarkStatus: {
+      handler() {
+        let saved = true
+        Object.keys(this.questionsMarkStatus).forEach(key => {
+          if (!this.questionsMarkStatus[key].isSaved) saved = false
+        })
+        this.$emit('setSaved', saved)
+      },
+      deep: true,
+      immediate: true
+    },
+    // questionMarkInfoList: {
+    //   handler() {
+    //     console.log(this.questionMarkInfoList, 'questionMarkInfoList')
+    //   },
+    //   deep: true,
+    //   immediate: true
+    // }
   }
 }
 </script>
diff --git a/src/views/trials/trials-panel/reading/visit-review/components/FileViewer.vue b/src/views/trials/trials-panel/reading/visit-review/components/FileViewer.vue
index f247960b..25cb8fa5 100644
--- a/src/views/trials/trials-panel/reading/visit-review/components/FileViewer.vue
+++ b/src/views/trials/trials-panel/reading/visit-review/components/FileViewer.vue
@@ -78,7 +78,7 @@
             </div>
             <div class="dropdown-content">
               <!--v-if="readingTaskState < 2"-->
-              <ul  style="width:100px;">
+              <ul style="width:100px;">
                 <li v-for="i in customizeStandardsNoneDicom" :key="i.toolName" style="text-align:left;">
                   <a href="#" @click.prevent="setAnnotateToolActive(i.toolName)">
                     <svg-icon :icon-class="i.icon" class="svg-icon" style="margin-right: 5px;" />
@@ -234,6 +234,7 @@
 </template>
 <script>
 import { addNoneDicomMark, deleteTrialFileType, getCriterionReadingInfo } from '@/api/trials'
+import html2canvas from 'html2canvas'
 import {
   RenderingEngine,
   Enums,
@@ -296,6 +297,12 @@ export default {
       default() {
         return []
       }
+    },
+    ecrf: {
+      type: Object,
+      default() {
+        return {}
+      }
     }
   },
   data() {
@@ -342,7 +349,8 @@ export default {
       uploadStatus: 'upload',
       taskId: '',
       isReadingTaskViewInOrder: null,
-      trialCriterion: {}
+      trialCriterion: {},
+      saveCustomAnnotationTimer: null
     }
   },
   computed: {
@@ -607,7 +615,17 @@ export default {
         toolGroup.setToolPassive(EraserTool.toolName)
       })
     },
-
+    lengthscaleToolDisabled(saved) {
+      const viewportIds = ['canvas-0', 'canvas-1', 'canvas-2', 'canvas-3']
+      viewportIds.forEach(toolGroupId => {
+        const toolGroup = ToolGroupManager.getToolGroup(toolGroupId)
+        if (saved) {
+          toolGroup.setToolPassive(LengthscaleTool.toolName)
+        } else {
+          toolGroup.setToolEnabled(LengthscaleTool.toolName)
+        }
+      })
+    },
     // 加载图片回调
     stackNewImage(e) {
       const { detail } = e
@@ -919,96 +937,201 @@ export default {
         toolsEvents.ANNOTATION_REMOVED,
         this.annotationRemovedListener
       )
+      eventTarget.addEventListener(
+        toolsEvents.ANNOTATION_SELECTION_CHANGE,
+        this.annotationSelectionChangeListener
+      )
     },
     async annotationRemovedListener(e) {
       const { annotation } = e.detail
       try {
-        if (!annotation) return
-        if (this.readingTaskState === 2 && !annotation.annotationId) {
-          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID)
-          return false
+        // if ( this.resetAnnotation && this.isFusion ) return false
+        if (!annotation) return false
+        if (annotation.metadata.toolName === 'Lengthscale') {
+          await this.$confirm(
+            this.$t('trials:trials-list:table:LengthscaleIsDeleted')
+          )
+          const errorMsg = { message: 'Lengthscale Not delete' }
+          throw errorMsg
         }
+        if (this.readingTaskState === 2 && !annotation.data.label && annotation.metadata.toolName !== 'Lengthscale') return false
         if (this.readingTaskState === 2) {
           const errorMsg = { message: 'annotation Not allowed to operate' }
           throw errorMsg
         }
-        if (annotation.annotationId) {
-          await deleteTrialFileType(annotation.annotationId)
-        } else {
-          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID)
+        const i = this.tools.findIndex(i => i.toolName === annotation.metadata.toolName)
+        if (i === -1 && annotation.metadata.toolName !== 'Lengthscale') {
+          // 临时标记
+          return
         }
-        const renderingEngine = getRenderingEngine(renderingEngineId)
-        const viewport = renderingEngine.getViewport(`canvas-${this.activeCanvasIndex}`)
-        viewport.render()
-        const i = this.viewportInfos.findIndex(i => i.index === this.activeCanvasIndex)
-        const imageId = annotation.metadata.referencedImageId
-        const path = imageId.split(`web:${this.OSSclientConfig.basePath}`)[1]
-        const fileList = this.viewportInfos[i].fileList
-        const fileIndex = fileList.findIndex(f => f.Path === path)
-        if (annotation.metadata.toolName === 'Lengthscale') {
-          this.$emit('setPS', { NoneDicomFileId: fileList[fileIndex].Id, Path: fileList[fileIndex].Path, PS: null })
+        if (annotation.visitTaskId === this.taskInfo.VisitTaskId) {
+          this.$emit('getEcrf', { type: "verifyAnnotationIsBound", VisitTaskId: annotation.visitTaskId, annotation })
+          this.$nextTick(async () => {
+            try {
+              const isBound = this.ecrf.isBound
+              if (isBound && this.activeTool === 'Eraser') {
+                // '该标记已与问题进行绑定，不允许删除！'
+                this.$alert(this.$t('dicom3D:ReadPage:alert:MarkToQuestionNoDel'))
+                const errorMsg = { message: 'annotation Not allowed to operate' }
+                throw errorMsg
+              } else if (this.activeTool === 'Eraser') {
+                await this.$confirm(
+                  this.$t('trials:trials-list:table:isDeleted') +
+                  annotation.data.label +
+                  '?'
+                )
+                if (annotation.id) {
+                  let res = await deleteTrialFileType(annotation.id)
+                  if (!res.IsSuccess) throw ''
+                }
+
+                const renderingEngine = getRenderingEngine(renderingEngineId)
+                for (let i = 0; i < this.cells.length; i++) {
+                  const viewportId = `canvas-${i}`
+                  const viewport = renderingEngine.getViewport(viewportId)
+                  viewport.render()
+                }
+              } else {
+                const errorMsg = { message: 'annotation Not allowed to operate' }
+                throw errorMsg
+              }
+            } catch (err) {
+              cornerstoneTools.annotation.state.addAnnotation(annotation)
+              const renderingEngine = getRenderingEngine(renderingEngineId)
+              for (let i = 0; i < this.cells.length; i++) {
+                const viewportId = `canvas-${i}`
+                const viewport = renderingEngine.getViewport(viewportId)
+                viewport.render()
+              }
+              console.log(e)
+            }
+          })
+
         }
       } catch (e) {
         cornerstoneTools.annotation.state.addAnnotation(annotation)
         const renderingEngine = getRenderingEngine(renderingEngineId)
-        const viewport = renderingEngine.getViewport(`canvas-${this.activeCanvasIndex}`)
-        viewport.render()
+        for (let i = 0; i < this.cells.length; i++) {
+          const viewportId = `canvas-${i}`
+          const viewport = renderingEngine.getViewport(viewportId)
+          viewport.render()
+        }
         console.log(e)
       }
-
     },
     async annotationModifiedListener(e) {
       console.log('Modified')
       if (this.readingTaskState === 2) return
       const { annotation } = e.detail
+      if (!annotation.highlighted) return
       if (!annotation) return
-      if (!annotation.annotationId) return
-      if (annotation.metadata.toolName === 'PlanarFreehandROI' && !annotation.data.contour.closed) return
-      const i = this.viewportInfos.findIndex(i => i.index === this.activeCanvasIndex)
-      if (i === -1) return
-      if (this.viewportInfos[i].taskInfo.VisitTaskId !== this.taskInfo.VisitTaskId) return
+      // if (!annotation.annotationId) return
+      let i = this.tools.findIndex(i => i.toolName === annotation.metadata.toolName)
+      if (i === -1 && annotation.metadata.toolName !== 'Lengthscale') {
+        this.setToolsPassive()
+        return
+      }
+      i = this.viewportInfos.findIndex(i => i.index === this.activeCanvasIndex)
       const imageId = annotation.metadata.referencedImageId
       const path = imageId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const fileList = this.viewportInfos[i].fileList
       const fileIndex = fileList.findIndex(f => f.Path === path)
       if (fileIndex === -1) return
+      annotation.path = path
+      let ps = null
+      let psIndex = this.psArr.findIndex(i => i.Path === path)
+      if (psIndex > -1 && this.psArr[i].PS) {
+        ps = parseFloat(this.psArr[i].PS).toFixed(3)
+      }
+      annotation.ps = ps
+      if (!annotation.data.label && annotation.metadata.toolName !== 'Lengthscale') return
+      if (annotation.metadata.toolName === 'PlanarFreehandROI' && !annotation.data.contour.closed) return
       if (annotation.metadata.toolName === 'Lengthscale') {
         const value = annotation.data.l
+        let ps = 1
         if (value) {
           const cachedStats = Object.keys(annotation.data.cachedStats)
-          const ps = value / annotation.data.cachedStats[cachedStats[0]].length
+          ps = value / annotation.data.cachedStats[cachedStats[0]].length
           annotation.data.ps = ps
-          this.$emit('setPS', { NoneDicomFileId: fileList[fileIndex].Id, Path: fileList[fileIndex].Path, PS: ps })
+          this.$emit('setPS', { NoneDicomFileId: fileList[fileIndex].Id, Path: fileList[fileIndex].Path, PS: ps, OldPS: 1 })
         }
         this.setToolsPassive()
+        if (this.customizeStandardsNoneDicom.find(item => item.toolName === annotation.metadata?.toolName)) return false
+        if (this.saveCustomAnnotationTimer) {
+          clearTimeout(this.saveCustomAnnotationTimer)
+          this.saveCustomAnnotationTimer = null
+        }
+        let psIndex = this.psArr.findIndex(p => p.NoneDicomFileId === fileList[fileIndex].Id)
+        let OldPS = 1
+        if (psIndex > -1) {
+          OldPS = this.psArr[i].OldPS
+        }
+        console.log(OldPS, ps)
+        let Proportion = ps / OldPS
+        return this.saveCustomAnnotationTimer = setTimeout(async () => {
+          console.log(this.ecrf.IsHaveBindingQuestion, 'this.ecrf.IsHaveBindingQuestion')
+          if (OldPS === ps || !this.ecrf.IsHaveBindingQuestion) {
+            this.saveCustomAnnotation(annotation)
+          } else {
+            await this.$confirm(
+              this.$t('trials:trials-list:table:allQuestionChange')
+            ).then(() => {
+              this.saveCustomAnnotation(annotation, Proportion)
+            })
+              .catch(action => {
+                this.saveCustomAnnotation(annotation, -1)
+              });
+          }
+        }, 500)
       }
-      if (this.customizeStandardsNoneDicom.find(item => item.toolName === annotation.metadata?.toolName)) return false
-      const params = {
-        id: annotation.annotationId,
-        visitTaskId: this.viewportInfos[i].taskInfo.VisitTaskId,
-        studyId: this.viewportInfos[i].studyId,
-        noneDicomFileId: fileList[fileIndex].Id,
-        path: fileList[fileIndex].Path,
-        measureData: JSON.stringify(annotation)
-      }
-      await addNoneDicomMark(params)
-      // 保存成功
-      // this.$message.success(this.$t('common:message:savedSuccessfully'))
+      this.$emit("getEcrf", { type: "getOperateStateEnum", VisitTaskId: this.taskInfo.VisitTaskId })
+      this.$emit('getEcrf', { type: "verifyAnnotationIsBound", VisitTaskId: this.taskInfo.VisitTaskId, annotation })
+      this.$nextTick(() => {
+        const operateStateEnum = this.ecrf.operateStateEnum
+        const isBound = this.ecrf.isBound
+        if (isBound || this.isNumber(operateStateEnum)) {
+          console.log(isBound, this.isNumber(operateStateEnum))
+          this.$emit('getEcrf', { type: "updateAnnotationToQuestion", VisitTaskId: this.taskInfo.VisitTaskId, annotation })
+        } else {
+          if (this.saveCustomAnnotationTimer) {
+            clearTimeout(this.saveCustomAnnotationTimer)
+            this.saveCustomAnnotationTimer = null
+          }
+          this.saveCustomAnnotationTimer = setTimeout(() => { this.saveCustomAnnotation(annotation) }, 1000)
+        }
+        this.setToolsPassive()
+      })
     },
     async annotationCompletedListener(e) {
       console.log('Completed')
       if (this.readingTaskState === 2) return
       const { annotation } = e.detail
       if (!annotation) return
-      if (annotation.metadata.toolName === 'PlanarFreehandROI' && !annotation.data.contour.closed) return
       const i = this.viewportInfos.findIndex(i => i.index === this.activeCanvasIndex)
-      if (i === -1) return
+      let INDEX = this.tools.findIndex(i => i.toolName === annotation.metadata.toolName)
+      if ((INDEX === -1 && annotation.metadata.toolName !== 'Lengthscale') || i === -1) {
+        this.setToolsPassive()
+        return
+      }
+
+      if (annotation.metadata.toolName === 'PlanarFreehandROI' && !annotation.data.contour.closed) return
       if (this.viewportInfos[i].taskInfo.VisitTaskId !== this.taskInfo.VisitTaskId) return
       const imageId = annotation.metadata.referencedImageId
       const path = imageId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const fileList = this.viewportInfos[i].fileList
       const fileIndex = fileList.findIndex(f => f.Path === path)
       if (fileIndex === -1) return
+      annotation.path = path
+      let ps = null
+      let psIndex = this.psArr.findIndex(i => i.Path === path)
+      if (psIndex > -1 && this.psArr[i].PS) {
+        ps = parseFloat(this.psArr[i].PS).toFixed(3)
+      }
+      annotation.ps = ps
+      annotation.markTool = annotation.metadata.toolName
+      annotation.visitTaskId = this.viewportInfos[i].taskInfo.VisitTaskId
+      annotation.studyId = this.viewportInfos[i].studyId
+      annotation.noneDicomFileId = this.viewportInfos[i].fileList[this.viewportInfos[i].currentImageIdIndex].Id
       if (annotation.metadata.toolName === 'Lengthscale') {
         this.form.annotationObj = {
           id: '',
@@ -1025,23 +1148,139 @@ export default {
         this.setToolsPassive()
         return
       }
-      if (this.customizeStandardsNoneDicom.find(item => item.toolName === annotation.metadata?.toolName)) return false
-      const params = {
-        id: '',
-        visitTaskId: this.viewportInfos[i].taskInfo.VisitTaskId,
-        studyId: this.viewportInfos[i].studyId,
-        noneDicomFileId: fileList[fileIndex].Id,
-        path: fileList[fileIndex].Path,
-        measureData: JSON.stringify(annotation)
-      }
-      const res = await addNoneDicomMark(params)
-      annotation.annotationId = res.Result
+      // this.markedSeriesIds.push(series.Id)
+      this.$emit('getEcrf', { type: "getOperateStateEnum", VisitTaskId: this.taskInfo.VisitTaskId })
 
-      const renderingEngine = getRenderingEngine(renderingEngineId)
-      const viewport = renderingEngine.getViewport(`canvas-${this.activeCanvasIndex}`)
-      viewport.render()
-      // 保存成功
-      // this.$message.success(this.$t('common:message:savedSuccessfully'))
+      this.$nextTick(async () => {
+        const operateStateEnum = this.ecrf.operateStateEnum
+        const markName = await this.customPrompt(!this.isNumber(operateStateEnum))
+
+        if (markName) {
+          annotation.data.label = markName
+          if (annotation.metadata.toolName === 'ArrowAnnotate') {
+            annotation.data.text = markName
+          }
+          if (this.isNumber(operateStateEnum)) {
+            this.$emit('getEcrf', { type: "bindAnnotationToQuestion", VisitTaskId: this.taskInfo.VisitTaskId, annotation })
+          } else {
+            if (this.saveCustomAnnotationTimer) {
+              clearTimeout(this.saveCustomAnnotationTimer)
+              this.saveCustomAnnotationTimer = null
+            }
+            this.saveCustomAnnotationTimer = setTimeout(() => { this.saveCustomAnnotation(annotation) }, 500)
+          }
+        } else {
+          // if (this.isNumber(operateStateEnum)) {
+          //   this.removeAnnotation(annotation)
+          // }  
+        }
+      })
+    },
+    annotationSelectionChangeListener(e) {
+      console.log('selection')
+      if (this.readingTaskState === 2) return
+      const { detail } = e
+      const annotations = cornerstoneTools.annotation.state.getAllAnnotations()
+      const i = annotations.findIndex(i => i.annotationUID === detail.selection[0])
+      if (i > -1) {
+        if (annotations[i].visitTaskId !== this.taskInfo.VisitTaskId) {
+          return
+        } else {
+          this.$emit('getEcrf', { type: "bindAnnotationToQuestion", VisitTaskId: this.taskInfo.VisitTaskId, annotation: annotations[i] })
+        }
+      }
+    },
+    async saveCustomAnnotation(annotation, ps = null) {
+      try {
+        const measureData = Object.assign({}, annotation)
+        const params = {}
+        const i = this.viewportInfos.findIndex(i => i.index === this.activeCanvasIndex)
+        await this.getScreenshots({
+          visitTaskId: this.taskInfo.VisitTaskId,
+          annotation
+        }, async (base64Str) => {
+          const pictureObj = await this.uploadScreenshots(`${Date.now()}`, base64Str)
+          let picturePath = pictureObj.isSuccess ? this.$getObjectName(pictureObj.result.url) : ''
+          if (annotation.id) params.Id = annotation.id
+          if (!isNaN(parseFloat(ps))) params.Proportion = ps
+          params.PicturePath = picturePath
+          params.Path = annotation.path || ''
+          params.MarkTool = measureData.markTool
+          params.OrderMarkName = measureData.data.label
+          params.VisitTaskId = this.taskInfo.VisitTaskId
+          params.StudyId = annotation.studyId
+          params.NoneDicomFileId = annotation.noneDicomFileId
+          params.MeasureData = JSON.stringify(measureData)
+          params.MarkId = annotation.annotationUID
+          const res = await addNoneDicomMark(params)
+          annotation.markId = params.MarkId
+          annotation.id = res.Result
+          if (!isNaN(parseFloat(ps))) this.$emit('getEcrf', { type: "getQuestions", VisitTaskId: this.taskInfo.VisitTaskId })
+        })
+
+      } catch (e) {
+        this.loading = false
+        console.log(e)
+      }
+    },
+    async getScreenshots(measureData, callback) {
+      if (measureData) {
+        console.log(measureData, 'measureData')
+        // await this.imageLocation(measureData)
+        this.viewCustomAnnotation(measureData)
+        const divForDownloadViewport = document.querySelector(
+          `div[data-viewport-uid="canvas-${this.activeCanvasIndex}"]`
+        )
+        const canvas = await html2canvas(divForDownloadViewport)
+        const base64Str = canvas.toDataURL('image/png', 1)
+        callback(base64Str)
+      } else {
+        callback()
+      }
+    },
+    viewCustomAnnotation(obj) {
+      const i = this.viewportInfos.findIndex(i => i.taskInfo.VisitTaskId === obj.visitTaskId)
+      const imageId = obj.annotation.metadata.referencedImageId
+      const path = imageId.split(`web:${this.OSSclientConfig.basePath}`)[1]
+      const fileList = this.viewportInfos[i].fileList
+      const fileIndex = fileList.findIndex(f => f.Path === path)
+      let o = { fileInfo: fileList[fileIndex], fileList, visitTaskInfo: this.viewportInfos[i].taskInfo, studyId: this.viewportInfos[i].studyId }
+      this.setActiveCanvasImages(o)
+    },
+    async uploadScreenshots(fileName, file) {
+      try {
+        file = this.convertBase64ToBlob(file)
+        const trialId = this.$route.query.trialId
+        const taskInfo = JSON.parse(localStorage.getItem('taskInfo'))
+        const subjectId = taskInfo.SubjectId
+        const result = await this.OSSclient.put(`/${trialId}/Read/${subjectId}/${this.visitTaskId}/${fileName}.png`, file)
+        return { isSuccess: true, result: result }
+      } catch (e) {
+        console.log(e)
+        return { isSuccess: false, result: e }
+      }
+    },
+    convertBase64ToBlob(imageEditorBase64) {
+      const base64Arr = imageEditorBase64.split(',')
+      let imgtype = ''
+      let base64String = ''
+      if (base64Arr.length > 1) {
+        base64String = base64Arr[1]
+        imgtype = base64Arr[0].substring(
+          base64Arr[0].indexOf(':') + 1,
+          base64Arr[0].indexOf(';')
+        )
+      }
+      const bytes = atob(base64String)
+      const bytesCode = new ArrayBuffer(bytes.length)
+      const byteArray = new Uint8Array(bytesCode)
+      for (let i = 0; i < bytes.length; i++) {
+        byteArray[i] = bytes.charCodeAt(i)
+      }
+      return new Blob([bytesCode], { type: imgtype })
+    },
+    isNumber(value) {
+      return typeof value === 'number' && value !== null && !isNaN(value)
     },
     async saveForm() {
       const validate = await this.$refs.lengthForm.validate()
@@ -1050,32 +1289,45 @@ export default {
       const annotation = this.form.annotationObj.annotation
       const fileList = this.form.annotationObj.fileList
       const fileIndex = this.form.annotationObj.fileIndex
+      let ps = 1
       if (value) {
         annotation.data.l = parseFloat(value)
         const cachedStats = Object.keys(annotation.data.cachedStats)
-        const ps = parseFloat(value) / annotation.data.cachedStats[cachedStats[0]].length
+        ps = parseFloat(value) / annotation.data.cachedStats[cachedStats[0]].length
         annotation.data.ps = ps
-        this.$emit('setPS', { NoneDicomFileId: fileList[fileIndex].Id, Path: fileList[fileIndex].Path, PS: ps })
+        this.$emit('setPS', { NoneDicomFileId: fileList[fileIndex].Id, Path: fileList[fileIndex].Path, PS: ps, OldPS: 1 })
       } else {
         cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID)
         return
       }
       if (this.customizeStandardsNoneDicom.find(item => item.toolName === annotation.metadata?.toolName)) return false
-      const params = {
-        id: '',
-        visitTaskId: this.form.annotationObj.visitTaskId,
-        studyId: this.form.annotationObj.studyId,
-        noneDicomFileId: this.form.annotationObj.noneDicomFileId,
-        path: this.form.annotationObj.path,
-        measureData: JSON.stringify(annotation)
-      }
-      const res = await addNoneDicomMark(params)
-      annotation.annotationId = res.Result
-
-      const renderingEngine = getRenderingEngine(renderingEngineId)
-      const viewport = renderingEngine.getViewport(`canvas-${this.activeCanvasIndex}`)
-      viewport.render()
       this.dialogVisible = false
+      if (this.saveCustomAnnotationTimer) {
+        clearTimeout(this.saveCustomAnnotationTimer)
+        this.saveCustomAnnotationTimer = null
+      }
+      let psIndex = this.psArr.findIndex(p => p.NoneDicomFileId === fileList[fileIndex].Id)
+      let OldPS = 1
+      if (psIndex > -1) {
+        OldPS = this.psArr[psIndex].OldPS
+      }
+      console.log(OldPS, 'OldPS')
+      let Proportion = ps / OldPS
+      return this.saveCustomAnnotationTimer = setTimeout(async () => {
+        if (!this.ecrf.IsHaveBindingQuestion) {
+          this.saveCustomAnnotation(annotation)
+        } else {
+          await this.$confirm(
+            this.$t('trials:trials-list:table:allQuestionChange')
+          ).then(() => {
+            this.saveCustomAnnotation(annotation, Proportion)
+          })
+            .catch(action => {
+              this.saveCustomAnnotation(annotation, -1)
+            });
+        }
+      }, 500)
+      this.saveCustomAnnotationTimer = setTimeout(() => { this.saveCustomAnnotation(annotation) }, 500)
     },
     getLengthscaleToolTextLines(data, targetId) {
       const cachedVolumeStats = data.cachedStats[targetId]
@@ -1087,6 +1339,9 @@ export default {
         return
       }
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       textLines.push(`P: ${parseFloat(length).toFixed(this.digitPlaces)} ${unit}`)
       if (data.l) {
         textLines.push(`L: ${parseFloat(data.l).toFixed(this.digitPlaces)} mm`)
@@ -1097,7 +1352,7 @@ export default {
     // 直线工具注释
     getLengthToolTextLines(data, targetId) {
       const cachedVolumeStats = data.cachedStats[targetId]
-      const { length, unit } = cachedVolumeStats
+      let { length, unit } = cachedVolumeStats
       if (length === undefined || length === null || isNaN(length)) {
         return
       }
@@ -1108,6 +1363,9 @@ export default {
         ps = parseFloat(this.psArr[i].PS).toFixed(3)
       }
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       if (ps) {
         textLines.push(`${this.reRound(csUtils.roundNumber(length * ps), this.digitPlaces)} mm`)
       } else {
@@ -1131,6 +1389,9 @@ export default {
       } = cachedVolumeStats || {}
 
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       let ps = null
       const path = targetId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const i = this.psArr.findIndex(i => i.Path === path)
@@ -1180,6 +1441,9 @@ export default {
       }
 
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       let ps = null
       const path = targetId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const i = this.psArr.findIndex(i => i.Path === path)
@@ -1216,6 +1480,9 @@ export default {
       }
 
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       let ps = null
       const path = targetId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const i = this.psArr.findIndex(i => i.Path === path)
@@ -1242,6 +1509,9 @@ export default {
       }
 
       const textLines = []
+      if (data.label) {
+        textLines.push(data.label)
+      }
       let ps = null
       const path = targetId.split(`web:${this.OSSclientConfig.basePath}`)[1]
       const i = this.psArr.findIndex(i => i.Path === path)
@@ -1300,16 +1570,77 @@ export default {
       viewport.resetCamera({ resetPan: true, resetZoom: true, resetToCenter: true })
       renderingEngine.render()
     },
-    // 箭头工具输入标记名称自定义弹窗
-    async customPrompt() {
+    resetAnnotations({ annotations, visitTaskId }) {
+      // 移除病灶
+      const arr = cornerstoneTools.annotation.state.getAllAnnotations()
+      arr.map(i => {
+        if (i.visitTaskId === visitTaskId) {
+          cornerstoneTools.annotation.state.removeAnnotation(i.annotationUID)
+        }
+      })
+      annotations.map(i => {
+        if (i.MeasureData) {
+          const annotation = i.MeasureData
+          cornerstoneTools.annotation.state.addAnnotation(annotation)
+        }
+      })
+      const renderingEngine = getRenderingEngine(renderingEngineId)
+      for (let i = 0; i < this.cells.length; i++) {
+        const viewportId = `canvas-${i}`
+        const viewport = renderingEngine.getViewport(viewportId)
+        viewport.render()
+      }
+    },
+    // 输入标记名称自定义弹窗
+    async customPrompt(isShowCancelButton = true) {
       try {
+        const that = this
         // 请输入标记名称
-        const { value } = await this.$prompt(this.$t('trials:noneDicom:message:msg1'))
+        let message = this.$t('trials:noneDicom:message:msg1')
+        // if (isShowCancelButton) {
+        //   message = `<div><p>${this.$t('trials:noneDicom:message:msg1')}</p><p style='font-size:12px' class='customPromptTip'>${this.$t('trials:noneDicom:message:saveTip')}</p></div>`
+        // }
+        const { value } = await this.$prompt(message, '', {
+          showClose: false,
+          cancelButtonText: isShowCancelButton ? this.$t('trials:reading:button:temporarySave') : this.$t('common:button:cancel'),
+          confirmButtonText: isShowCancelButton ? this.$t('trials:reading:button:enduringSave') : this.$t('trials:reading:button:relevancy'),
+          // showCancelButton: isShowCancelButton,
+          // dangerouslyUseHTMLString: isShowCancelButton,
+          inputValidator: (res) => {
+            if (!res) {
+              return isShowCancelButton ? this.$t('trials:noneDicom:message:saveTip') : this.$t('trials:noneDicom:message:saveTipByRelevancy')
+            }
+          },
+          inputErrorMessage: this.$t('trials:noneDicom:message:saveTip'),
+          showCancelButton: true,
+          closeOnClickModal: false,
+          closeOnPressEscape: false,
+          beforeClose: (action, instance, done) => {
+            if (action === 'confirm') {
+              const value = instance.inputValue
+              if (!value) {
+                that.$message.error(this.$t('trials:customReading:error:validMarkName1'))
+              } else if (this.validMarkName(value)) {
+                that.$message.error(this.$t('trials:customReading:error:validMarkName'))
+              } else {
+                done()
+              }
+            } else {
+              done()
+            }
+          }
+        })
         return value
-      } catch {
+      } catch (err) {
+        console.log(err)
         return null
       }
     },
+    validMarkName(markName) {
+      const annotations = cornerstoneTools.annotation.state.getAllAnnotations()
+      const i = annotations.findIndex(i => i.visitTaskId === this.taskInfo.VisitTaskId && i.data.label === markName)
+      return i > -1
+    },
     // 滚动条
     clickSlider(e, index) {
       const height = e.offsetY * 100 / this.$refs[`sliderBox-${index}`][0].clientHeight
diff --git a/src/views/trials/trials-panel/reading/visit-review/components/ReadPage.vue b/src/views/trials/trials-panel/reading/visit-review/components/ReadPage.vue
index 6eedab56..d6e72077 100644
--- a/src/views/trials/trials-panel/reading/visit-review/components/ReadPage.vue
+++ b/src/views/trials/trials-panel/reading/visit-review/components/ReadPage.vue
@@ -35,13 +35,13 @@
         @toggleTask="toggleTask"
         @toggleImage="toggleImage"
       /> -->
-      <file-viewer ref="fileViewer" :related-study-info="relatedStudyInfo" :ps-arr="psArr"
+      <file-viewer ref="fileViewer" :related-study-info="relatedStudyInfo" :ps-arr="psArr" :ecrf="ecrf"
         @toggleTaskByViewer="toggleTaskByViewer" @toggleTask="toggleTask" @toggleImage="toggleImage"
-        @previewCD="previewCD" @setPS="setPS" />
+        @previewCD="previewCD" @setPS="setPS" @getEcrf="getEcrf" />
     </div>
     <!-- 表单 -->
     <div class="right-panel">
-      <div v-if="taskInfo && taskInfo.IsReadingShowSubjectInfo" class="text-info">
+      <!-- <div v-if="taskInfo && taskInfo.IsReadingShowSubjectInfo" class="text-info">
         <h3>
           <span v-if="currentVisitInfo && currentVisitInfo.SubjectCode">
             {{ currentVisitInfo.SubjectCode }}
@@ -50,15 +50,20 @@
             {{ currentVisitInfo.TaskBlindName }}
           </span>
         </h3>
-      </div>
+      </div> -->
       <!-- <ecrf-list
         v-if="currentVisitInfo"
         :visit-task-info="currentVisitInfo"
       /> -->
-      <customize-question-list v-if="currentVisitInfo.VisitTaskId" :ref="`ecrf_1`" :reading-task-state="1"
-        :visit-info="currentVisitInfo" @resetAnnotations="resetAnnotations" @setReadingTaskState="setReadingTaskState"
-        @viewCustomAnnotationSeries="viewCustomAnnotationSeries" @getCustomScreenshots="getCustomScreenshots"
-        @setReadingToolActive="setReadingToolActive" @setReadingToolPassive="setReadingToolPassive" />
+      <div v-for="s in visitTaskList" v-show="lastViewportTaskId === s.VisitTaskId" :key="s.VisitTaskId"
+        style="height: 100%;">
+        <customize-question-list v-if="lastViewportTaskId" :ref="`ecrf_${s.VisitTaskId}`" :isNoneDicom="true"
+          :reading-task-state="readingTaskState" :visit-info="currentVisitInfo" @resetAnnotations="resetAnnotations"
+          @setReadingTaskState="setReadingTaskState" @viewCustomAnnotationSeries="viewCustomAnnotationSeries"
+          @getCustomScreenshots="getCustomScreenshots" @setReadingToolActive="setReadingToolActive"
+          @setReadingToolPassive="setReadingToolPassive" @setSaved="setSaved"
+          @setIsHaveBindingQuestion="setIsHaveBindingQuestion" />
+      </div>
     </div>
 
     <el-dialog :visible.sync="clinicalDataVisible"
@@ -125,7 +130,11 @@ export default {
       isClinicalDataFullscreen: false,
       trialId: '',
       cdVisitTaskId: '',
-      psArr: []
+      psArr: [],
+      readingTaskState: 0,
+      ecrf: {
+        IsHaveBindingQuestion: false
+      }
     }
   },
   computed: {
@@ -147,29 +156,73 @@ export default {
   mounted() {
     this.taskInfo = JSON.parse(localStorage.getItem('taskInfo'))
     this.trialId = this.$route.query.trialId
+    this.readingTaskState = this.taskInfo.ReadingTaskState
     this.getRelatedTask()
   },
   methods: {
-    resetAnnotations() { },
-    setReadingTaskState() { },
-    viewCustomAnnotationSeries() { },
-    getCustomScreenshots() { },
-    setReadingToolPassive() { },
+    getEcrf(data) {
+      let { type } = data
+      if (type === 'getOperateStateEnum') {
+        this.ecrf.operateStateEnum = this.$refs[`ecrf_${data.VisitTaskId}`][0].operateStateEnum
+      }
+      if (type === 'bindAnnotationToQuestion') {
+        this.$refs[`ecrf_${data.VisitTaskId}`][0].bindAnnotationToQuestion(data.annotation)
+      }
+      if (type === 'updateAnnotationToQuestion') {
+        this.$refs[`ecrf_${data.VisitTaskId}`][0].updateAnnotationToQuestion(data.annotation)
+      }
+      if (type === 'verifyAnnotationIsBound') {
+        this.ecrf.isBound = this.$refs[`ecrf_${data.VisitTaskId}`][0].verifyAnnotationIsBound(data.annotation)
+      }
+      if (type === 'getQuestions') {
+        this.ecrf.isBound = this.$refs[`ecrf_${data.VisitTaskId}`][0].getQuestions()
+      }
+    },
+    setSaved(saved) {
+      this.$refs.fileViewer.lengthscaleToolDisabled(saved)
+    },
+    setIsHaveBindingQuestion(flag) {
+      this.ecrf.IsHaveBindingQuestion = flag
+    },
+    async resetAnnotations(visitTaskId) {
+      if (this.readingTaskState === 2) return
+      const taskIdx = this.visitTaskList.findIndex(i => i.VisitTaskId === visitTaskId)
+      if (taskIdx === -1) return
+      if (!this.visitTaskList[taskIdx].IsCurrentTask) return
+      // 获取标注信息
+      let res = await getNoneDicomMarkListOutDto({ visitTaskId: visitTaskId })
+
+      const annotations = res.Result.NoneDicomMarkList.map(i => {
+        if (typeof i.MeasureData === 'string' && i.MeasureData) {
+          i.MeasureData = JSON.parse(i.MeasureData)
+          i.MeasureData.markId = i.MarkId
+          i.MeasureData.id = i.Id
+        }
+        this.psArr = []
+        if (i.MeasureData.metadata.toolName === 'Lengthscale' && this.psArr.findIndex(p => p.NoneDicomFileId === i.NoneDicomFileId) === -1) {
+          this.psArr.push({ NoneDicomFileId: i.NoneDicomFileId, Path: i.Path, PS: i.MeasureData.data.ps, OldPS: i.MeasureData.data.ps })
+        }
+        return i
+      })
+      this.$set(this.visitTaskList[taskIdx], 'Annotations', annotations)
+      // this.$refs.fileViewer.resetAnnotations({ annotations, visitTaskId })
+    },
+    setReadingTaskState(state) {
+      this.readingTaskState = state
+    },
+    viewCustomAnnotationSeries(obj) {
+      this.$refs.fileViewer.viewCustomAnnotation(obj)
+    },
+    getCustomScreenshots(obj, callback) {
+      this.$refs.fileViewer.getScreenshots(obj, callback)
+    },
+    setReadingToolPassive() {
+      this.$refs.fileViewer.setToolsPassive()
+    },
     setReadingToolActive(toolName) {
       if (this.readingTaskState === 2) return
       if (this.activeTool === toolName) return
-      const series = this.$refs[`${this.viewportKey}-${this.activeViewportIndex}`][0].series
-      if (series && series.TaskInfo.VisitTaskId && series.TaskInfo.VisitTaskId === this.taskInfo.VisitTaskId) {
-        const toolGroupId = `${this.viewportKey}-${this.activeViewportIndex}`
-        const toolGroup = ToolGroupManager.getToolGroup(toolGroupId)
-        if (this.activeTool) {
-          toolGroup.setToolPassive(this.activeTool)
-        }
-        toolGroup.setToolActive(toolName, {
-          bindings: [{ mouseButton: MouseBindings.Primary }]
-        })
-        this.activeTool = toolName
-      }
+      this.$refs.fileViewer.setToolActive(toolName)
     },
     // 获取关联任务信息
     async getRelatedTask() {
@@ -254,9 +307,11 @@ export default {
           const arr = res.Result.NoneDicomMarkList.map(i => {
             if (typeof i.MeasureData === 'string') {
               i.MeasureData = JSON.parse(i.MeasureData)
+              i.MeasureData.markId = i.MarkId
+              i.MeasureData.id = i.Id
             }
             if (i.MeasureData.metadata.toolName === 'Lengthscale' && this.psArr.findIndex(p => p.NoneDicomFileId === i.NoneDicomFileId) === -1) {
-              this.psArr.push({ NoneDicomFileId: i.NoneDicomFileId, Path: i.Path, PS: i.MeasureData.data.ps })
+              this.psArr.push({ NoneDicomFileId: i.NoneDicomFileId, Path: i.Path, PS: i.MeasureData.data.ps, OldPS: i.MeasureData.data.ps })
             }
             return i
           })