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 5e8a314f..25d707b8 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
@@ -652,8 +652,8 @@ export default {
         }
         annotation = this.getAnnotationByRow(this.operateRowId)
         // 截图上传
-        let picturePath = ''
-        if (annotation) {
+        let picturePath = obj.picturePath
+        if (annotation && !picturePath) {
           const base64Str = await this.getScreenshots({
             visitTaskId: this.visitTaskId,
             annotation
@@ -686,6 +686,17 @@ export default {
           { 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 {
diff --git a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionTableFormItem.vue b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionTableFormItem.vue
index a1f63b50..0adc6c3b 100644
--- a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionTableFormItem.vue
+++ b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionTableFormItem.vue
@@ -195,6 +195,7 @@
   </div>
 </template>
 <script>
+import DicomEvent from '@/views/trials/trials-panel/reading/dicoms/components/DicomEvent'
 export default {
   name: 'QuestionTableFormItem',
   props: {
@@ -294,7 +295,6 @@ export default {
     }
   },
   mounted() {
-
     var digitPlaces = Number(localStorage.getItem('digitPlaces'))
     this.digitPlaces = digitPlaces === -1 ? this.digitPlaces : digitPlaces
     if (this.question.Type === 'upload') {
@@ -306,6 +306,12 @@ export default {
         })
       }
     }
+    DicomEvent.$on('operateImageMarkerTable', (data) => {
+      let { operateStateEnum, QuestionId, picturePath } = data
+      if (this.question.Id === QuestionId) {
+        this.operateImageMarker({ operateStateEnum, question: this.question, picturePath })
+      }
+    })
     if (this.type === 'edit') return
   },
   methods: {