diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/Questions.vue b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/Questions.vue
index 7f64b4c6..2a46a734 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Fusion/Questions.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Fusion/Questions.vue
@@ -64,7 +64,9 @@ export default {
       lungIsInsideVolume: true,
       liverIsInsideVolume: true,
       uptakeFromBaselineId: '',
-      baseLinePET5PS: null
+      baseLinePET5PS: null,
+      liverRender: true,
+      lungRender: true
     }
   },
   computed: {
@@ -98,7 +100,7 @@ export default {
     this.isBaseLineTask = this.$route.query.isBaseLineTask === 'true'
     this.initPage()
     FusionEvent.$on('refreshQuestions', () => {
-      this.initList()
+      this.initList(false)
     })
     FusionEvent.$on('resetSuvQuestions', () => {
       console.log('resetSuvQuestions')
@@ -159,9 +161,9 @@ export default {
         this.baseLinePET5PS = res.Result.BaseLinePET5PS
         this.loading = false
       }
-      this.initList()
+      this.initList(true)
     },
-    initList() {
+    initList(isInit) {
       this.loading = true
       var params = {
         trialId: this.trialId,
@@ -188,6 +190,11 @@ export default {
         res.OtherInfo.QuestionMarkInfoList.forEach(i => {
           if (i.OtherMeasureData) {
             i.OtherMeasureData = JSON.parse(i.OtherMeasureData)
+            if (i.QuestionType === 51 && isInit) {
+              this.liverRender = false
+            } else if (i.QuestionType === 52 && isInit) {
+              this.lungRender = false
+            }
           }
           this.measurements.push(i)
         })
@@ -297,7 +304,6 @@ export default {
         this.loading = false
         this.questionFormChangeState = false
         this.$message({ message: this.$t('common:message:savedSuccessfully'), type: 'success', duration: 2000 })
-        
       }).catch(() => {
         this.loading = false
       })
@@ -357,7 +363,7 @@ export default {
       FusionEvent.$emit('imageLocation', { otherMeasureData: otherMeasureData })
     },
     saveAnnotation(question) {
-      if((question.QuestionType === 51 && !this.liverIsInsideVolume) || (question.QuestionType === 52 && !this.lungIsInsideVolume)){
+      if ((question.QuestionType === 51 && !this.liverIsInsideVolume) || (question.QuestionType === 52 && !this.lungIsInsideVolume)) {
         // 当前标记在图像外
         this.$alert(this.$t('trials:reading:lugano:warnning:outsideVolume'), this.$t('trials:lugano:fusionDialog:warning'), {
           callback: action => {
@@ -406,7 +412,6 @@ export default {
           window.opener.postMessage({ type: 'petctLesionUpdate' }, window.location)
           loading.close()
           this.$message({ message: this.$t('common:message:savedSuccessfully'), type: 'success', duration: 2000 })
-          
         }).catch(() => {
           loading.close()
         })
@@ -456,7 +461,20 @@ export default {
         }
         FusionEvent.$emit('addOrUpdateAnnotations', { data })
         this.questionFormChangeState = true
-        this.setQuestionStatus(this.questions, this.measurements[idx].QuestionType)
+        if (obj.QuestionType === 51) {
+          if (!this.liverRender) {
+            this.liverRender = true
+          } else {
+            this.setQuestionStatus(this.questions, this.measurements[idx].QuestionType)
+          }
+        }
+        if (obj.QuestionType === 52) {
+          if (!this.lungRender) {
+            this.lungRender = true
+          } else {
+            this.setQuestionStatus(this.questions, this.measurements[idx].QuestionType)
+          }
+        }
       }
     },
     setQuestionStatus(obj, questionType) {
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 13a86d68..1527ea88 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
@@ -607,7 +607,23 @@ export default {
           if (!isInit) {
             // saveTypeEnum 0：未保存过（新建病灶）；1：已保存，信息不完整（随访初始化病灶/分裂病灶，通过状态判断）
             if (this.questionForm.RowId) {
-              this.$set(this.questionForm, 'saveTypeEnum', 1)
+              if (this.questionForm.OtherMeasureData && this.firstRenderAnnotation) {
+                var annotation = Object.assign({}, this.questionForm.OtherMeasureData)
+
+                if (annotation && this.firstRenderAnnotation) {
+                  for (const k in annotation.data.cachedStats) {
+                    if (annotation.data.cachedStats[k].pointsInShape.length !== 0) {
+                      this.firstRenderAnnotation = false
+                      break
+                    }
+                  }
+                }
+              }
+              if (this.firstRenderAnnotation) {
+                this.$set(this.questionForm, 'saveTypeEnum', 2)
+              } else {
+                this.$set(this.questionForm, 'saveTypeEnum', 1)
+              }
             } else {
               this.$set(this.questionForm, 'saveTypeEnum', 0)
             }