diff --git a/src/views/trials/trials-panel/reading/dicoms3D/components/ReadPage.vue b/src/views/trials/trials-panel/reading/dicoms3D/components/ReadPage.vue
index 5c8cbd8b..78b24879 100644
--- a/src/views/trials/trials-panel/reading/dicoms3D/components/ReadPage.vue
+++ b/src/views/trials/trials-panel/reading/dicoms3D/components/ReadPage.vue
@@ -595,7 +595,7 @@ const { createCameraPositionSynchronizer, createVOISynchronizer } = synchronizer
 const newStyles = {
   global: {
     color: 'rgb(255, 0, 0)',
-    colorHighlighted: 'rgb(255, 0, 0)',
+    colorHighlighted: 'rgb(0, 255, 0)',
     colorSelected: 'rgb(255, 0, 0)',
     colorLocked: 'rgb(255, 0, 0)',
     lineWidth: '1',
@@ -605,7 +605,7 @@ const newStyles = {
     textBoxFontFamily: 'Helvetica Neue, Helvetica, Arial, sans-serif',
     textBoxFontSize: '14px',
     textBoxColor: 'rgb(255, 0, 0)',
-    textBoxColorHighlighted: 'rgb(255, 0, 0)',
+    textBoxColorHighlighted: 'rgb(0, 255, 0)',
     textBoxColorSelected: 'rgb(255, 0, 0)',
     textBoxColorLocked: 'rgb(255, 0, 0)',
     textBoxBackground: '',
@@ -1328,6 +1328,11 @@ export default {
         toolsEvents.ANNOTATION_REMOVED,
         this.criterionType === 0 ? this.customAnnotationRemovedListener : this.annotationRemovedListener
       )
+      eventTarget.addEventListener(
+        toolsEvents.ANNOTATION_SELECTION_CHANGE,
+        this.criterionType === 0 ? this.customAnnotationSelectionChangeListener : this.annotationSelectionChangeListener
+      )
+      
       // eventTarget.addEventListener(
       //   toolsEvents.ANNOTATION_ADDED,
       //   this.annotationAddedListener
@@ -1427,8 +1432,9 @@ export default {
             annotation.data.text = markName
           }
           this.saveCustomAnnotation(annotation)
+          this.$refs[`ecrf_${series.TaskInfo.VisitTaskId}`][0].bindAnnotationToQuestion(annotation)
         }
-        this.$refs[`ecrf_${series.TaskInfo.VisitTaskId}`][0].bindAnnotationToQuestion(annotation)
+        
       }
       
       this.setToolsPassive()
@@ -1485,6 +1491,14 @@ export default {
           // 临时标记
           return
         }
+        if (annotation.visitTaskId === this.taskInfo.VisitTaskId) {
+          let isBound = this.$refs[`ecrf_${annotation.visitTaskId}`][0].verifyAnnotationIsBound(annotation)
+          if (isBound) {
+            this.$alert('该标记已与问题进行绑定，不允许删除！')
+            throw 'annotation Not allowed to operate'
+          }
+        }
+        
         if (annotation.visitTaskId === this.taskInfo.VisitTaskId && annotation.seriesId) {
           if (this.activeTool === 'Eraser') {
             await this.$confirm(
@@ -1529,6 +1543,20 @@ export default {
         viewport.render()
       }
     },
+    customAnnotationSelectionChangeListener(e) {
+      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.$refs[`ecrf_${this.taskInfo.VisitTaskId}`][0].bindAnnotationToQuestion(annotations[i])
+        }
+      }
+    },
+    annotationSelectionChangeListener(e) {},
     async getAnnotations(visitTaskId) {
       if (this.readingTaskState === 2) return
       const taskIdx = this.visitTaskList.findIndex(i => i.VisitTaskId === visitTaskId)
diff --git a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionFormItem.vue b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionFormItem.vue
index 22c6e7b1..b6b2805d 100644
--- a/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionFormItem.vue
+++ b/src/views/trials/trials-panel/reading/dicoms3D/components/customize/QuestionFormItem.vue
@@ -241,43 +241,43 @@
               </template>
             </el-input>
             <!-- 标记 -->
-            <!-- <el-button 
+            <el-button 
               v-if="readingTaskState < 2 && !questionsMarkStatus[question.Id]" 
               size="mini" 
               type="text"
               @click="operateImageMarker({operateStateEnum: 1, question})"
             >
               标记
-            </el-button> -->
+            </el-button>
             <!-- 查看 -->
-            <!-- <el-button 
+            <el-button 
               v-if="questionsMarkStatus[question.Id]"
               size="mini" 
               type="text"
               @click="operateImageMarker({operateStateEnum: 2, question})"
             >
               查看
-            </el-button> -->
+            </el-button>
             <!-- 更改 -->
-            <!-- <el-button 
+            <el-button 
               v-if="readingTaskState < 2 && questionsMarkStatus[question.Id]" 
               size="mini" 
               type="text"
               @click="operateImageMarker({operateStateEnum: 3, question})"
             >
               更改
-            </el-button> -->
+            </el-button>
             <!-- 移除 -->
-            <!-- <el-button 
+            <el-button 
               v-if="readingTaskState < 2 && questionsMarkStatus[question.Id]" 
               size="mini" 
               type="text"
               @click="operateImageMarker({operateStateEnum: 4, question})"
             > 
               移除
-            </el-button> -->
+            </el-button>
             <!-- 保存 -->
-            <!-- <el-button 
+            <el-button 
               v-if="readingTaskState < 2 && questionsMarkStatus[question.Id]" 
               size="mini" 
               type="text"
@@ -287,7 +287,7 @@
                 <i class="el-icon-warning" style="color:red" />
               </el-tooltip>
               保存
-            </el-button> -->
+            </el-button>
           </div>
         </template>
         <template v-else-if="question.Type === 'number'">
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 43e83b4b..8bec2eec 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
@@ -347,6 +347,10 @@ export default {
         }
       })
     },
+    verifyAnnotationIsBound(annotation) {
+      let i = this.questionMarkInfoList.findIndex(i=>i.MeasureData && i.MeasureData.annotationUID === annotation.annotationUID)
+      return i > -1
+    },
     async operateImageMarker(obj) {
       this.operateStateEnum = obj.operateStateEnum
       this.operateQuestionId = obj.question.Id
@@ -363,7 +367,7 @@ export default {
         
       } else if (obj.operateStateEnum === 3) {
         // 更改标记
-        this.$set(this.questionsMarkStatus, obj.question.Id, 1)
+        // this.$set(this.questionsMarkStatus, obj.question.Id, 1)
       } else if (obj.operateStateEnum === 4) {
         // 移除标记
         this.$set(this.questionForm, obj.question.Id, '')
@@ -402,9 +406,24 @@ export default {
       }
       
     },
-    bindAnnotationToQuestion(annotation) {
-      console.log('bindAnnotationToQuestion', annotation)
-      if (this.operateStateEnum === 1 && this.operateQuestionId) {
+    async bindAnnotationToQuestion(annotation) {
+      try {
+        if (!(this.operateStateEnum === 1 || this.operateStateEnum === 3)) return
+        if (!this.operateQuestionId) return
+        if (this.operateStateEnum === 3) {
+          if (!annotation.data.label) {
+            this.$alert('该标记不能与问题绑定！')
+            return
+          }
+          const confirm = await this.$confirm('是否确认更改？', {
+            type: 'warning',
+            distinguishCancelAndClose: true
+          })
+          if (confirm !== 'confirm') return
+          
+        }
+        console.log('bindAnnotationToQuestion', annotation)
+        
         let i = this.questionMarkInfoList.findIndex(i=>i.QuestionId === this.operateQuestionId)
         if (i === -1) {
           let markInfo = {
@@ -429,6 +448,9 @@ export default {
         }
         this.setAnswerToQuestion(annotation, this.operateQuestionId)
         this.$set(this.questionsMarkStatus, this.operateQuestionId, 1)
+        
+      } catch (e) {
+        console.log(e)
       }
     },
     updateAnnotationToQuestion(annotation) {