dros/src/utils/measurementToolManager.ts

import * as cornerstone from '@cornerstonejs/core';
import * as cornerstoneTools from '@cornerstonejs/tools';
import TibialPlateauAngleTool from '@/components/measures/TibialPlateauAngleTool';
import DARAMeasurementTool from '@/components/measures/DARAMeasurementTool';
import HipDIMeasurementTool from '@/components/measures/HipDIMeasurementTool';
import HipNHAAngleMeasurementTool from '@/components/measures/HipNHAAngleMeasurementTool';
import VHSMeasurementTool from '@/components/measures/VHSMeasurementTool';
import TPLOMeasurementTool from '@/components/measures/TPLOMeasurementTool';
import TTAMeasurementTool from '@/components/measures/TTAMeasurementTool';
import CBLOMeasurementTool from '@/components/measures/CBLOMeasurementTool';
import HipCoverageMeasurementTool from '@/components/measures/HipCoverageMeasurementTool';
import HipDorsalCoverageTool from '@/components/measures/HipDorsalCoverageTool';
import CircleCenterMeasurementTool from '@/components/measures/CircleCenterMeasurementTool';
import MidlineMeasurementTool from '@/components/measures/MidlineMeasurementTool';
import FindMidpointMeasurementTool from '@/components/measures/FindMidpointMeasurementTool';
import VerticalTiltMeasurementTool from '@/components/measures/VerticalTiltMeasurementTool';
import HorizontalTiltMeasurementTool from '@/components/measures/HorizontalTiltMeasurementTool';
import PolygonLengthMeasurementTool from '@/components/measures/PolygonLengthMeasurementTool';
import PolylineLengthMeasurementTool from '@/components/measures/PolylineLengthMeasurementTool';
import LineGrayscaleMeasurementTool from '@/components/measures/LineGrayscaleMeasurementTool';
import RectangleGrayscaleMeasurementTool from '@/components/measures/RectangleGrayscaleMeasurementTool';

const {
  ToolGroupManager,
  LengthTool,
  AngleTool,
  WindowLevelTool,
  MagnifyTool,
  Enums: csToolsEnums,
} = cornerstoneTools;

const { MouseBindings } = csToolsEnums;

/**
 * 测量工具管理器
 * 统一管理所有测量相关的工具操作
 */
export class MeasurementToolManager {
  /**
   * 根据 viewportId 获取对应的工具组
   */
  static getToolGroup(
    viewportId: string
  ): cornerstoneTools.Types.IToolGroup | undefined {
    const toolGroupId = `STACK_TOOL_GROUP_ID_${viewportId}`;
    const toolGroup = ToolGroupManager.getToolGroup(toolGroupId);

    if (!toolGroup) {
      console.warn(
        `[MeasurementToolManager] Tool group not found for viewport: ${viewportId}`
      );
    }

    return toolGroup;
  }

  /**
   * 激活线段测量工具
   */
  static activateLengthTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });

      // 激活线段测量工具
      toolGroup.setToolActive(LengthTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      console.log(
        `[MeasurementToolManager] Length tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating length tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用线段测量工具
   */
  static deactivateLengthTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] Length tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating length tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查线段测量工具是否处于激活状态
   */
  static isLengthToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === LengthTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换线段测量工具状态
   */
  static toggleLengthTool(viewportId: string): boolean {
    const isActive = this.isLengthToolActive(viewportId);

    if (isActive) {
      return this.deactivateLengthTool(viewportId);
    } else {
      return this.activateLengthTool(viewportId);
    }
  }

  /**
   * 激活角度测量工具
   */
  static activateAngleTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });

      // 激活角度测量工具
      toolGroup.setToolActive(AngleTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      console.log(
        `[MeasurementToolManager] Angle tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating angle tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用角度测量工具
   */
  static deactivateAngleTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] Angle tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating angle tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 清除指定 viewport 的所有线段测量标注
   */
  static clearLengthMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        LengthTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} length measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing measurements:`,
        error
      );
      return false;
    }
  }


  /**
   * 获取指定 viewport 的所有线段测量结果
   */
  // eslint-disable-next-line
  static getLengthMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        LengthTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        length: annotation.data?.cachedStats?.length || 0,
        unit: annotation.data?.cachedStats?.unit || 'mm',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活线段测量工具
   */
  static activateLengthToolForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.activateLengthTool(viewportId));
  }

  /**
   * 为多个 viewport 批量停用线段测量工具
   */
  static deactivateLengthToolForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateLengthTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除线段测量
   */
  static clearLengthMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearLengthMeasurements(viewportId)
    );
  }

  /**
   * 检查角度测量工具是否处于激活状态
   */
  static isAngleToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === AngleTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking angle tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换角度测量工具状态
   */
  static toggleAngleTool(viewportId: string): boolean {
    const isActive = this.isAngleToolActive(viewportId);

    if (isActive) {
      return this.deactivateAngleTool(viewportId);
    } else {
      return this.activateAngleTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有角度测量标注
   */
  static clearAngleMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        AngleTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} angle measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing angle measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有角度测量结果
   */
  // eslint-disable-next-line
  static getAngleMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        AngleTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        angle: annotation.data?.cachedStats?.angle || 0,
        unit: annotation.data?.cachedStats?.unit || 'degrees',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting angle measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活角度测量工具
   */
  static activateAngleToolForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.activateAngleTool(viewportId));
  }

  /**
   * 为多个 viewport 批量停用角度测量工具
   */
  static deactivateAngleToolForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateAngleTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除角度测量
   */
  static clearAngleMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearAngleMeasurements(viewportId)
    );
  }

  // ==================== 胫骨平台夹角测量工具 ====================

  /**
   * 激活胫骨平台夹角测量工具
   */
  static activateTibialPlateauAngleTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });

      // 激活胫骨平台夹角测量工具
      toolGroup.setToolActive(TibialPlateauAngleTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });
      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        TibialPlateauAngleTool.toolName
      ) as TibialPlateauAngleTool;
      // 使用参数中的 viewportId，而不是硬编码
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {


        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = TibialPlateauAngleTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              TibialPlateauAngleTool.toolName
            ) as TibialPlateauAngleTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          // 触发渲染更新
          const viewportIdsToRender = cornerstoneTools.utilities.viewportFilters.getViewportIdsWithToolToRender(
            viewport.element,
            TibialPlateauAngleTool.toolName
          );

          cornerstoneTools.utilities.triggerAnnotationRenderForViewportIds(
            viewportIdsToRender
          );

          console.log('[MeasurementToolManager] Default TPA annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] TibialPlateauAngle tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating TibialPlateauAngle tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用胫骨平台夹角测量工具
   */
  static deactivateTibialPlateauAngleTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] TibialPlateauAngle tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating TibialPlateauAngle tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查胫骨平台夹角测量工具是否处于激活状态
   */
  static isTibialPlateauAngleToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === TibialPlateauAngleTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking TibialPlateauAngle tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换胫骨平台夹角测量工具状态
   */
  static toggleTibialPlateauAngleTool(viewportId: string): boolean {
    const isActive = this.isTibialPlateauAngleToolActive(viewportId);

    if (isActive) {
      return this.deactivateTibialPlateauAngleTool(viewportId);
    } else {
      return this.activateTibialPlateauAngleTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有胫骨平台夹角测量标注
   */
  static clearTibialPlateauAngleMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TibialPlateauAngleTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} TibialPlateauAngle measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing TibialPlateauAngle measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有胫骨平台夹角测量结果
   */
  // eslint-disable-next-line
  static getTibialPlateauAngleMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TibialPlateauAngleTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        TPA: annotation.data?.cachedStats?.TPA || 0,
        unit: 'degrees',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting TibialPlateauAngle measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活胫骨平台夹角测量工具
   */
  static activateTibialPlateauAngleToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateTibialPlateauAngleTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用胫骨平台夹角测量工具
   */
  static deactivateTibialPlateauAngleToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateTibialPlateauAngleTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除胫骨平台夹角测量
   */
  static clearTibialPlateauAngleMeasurementsForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearTibialPlateauAngleMeasurements(viewportId)
    );
  }

  // ==================== 髋臼水平角测量工具 ====================

  /**
   * 激活髋臼水平角测量工具
   */
  static activateDARAMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });

      // 激活髋臼水平角测量工具
      toolGroup.setToolActive(DARAMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });
      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        DARAMeasurementTool.toolName
      ) as DARAMeasurementTool;
      // 使用参数中的 viewportId，而不是硬编码
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }
      // 自动创建一个预设的注解
      try {
        const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;

        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = DARAMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              DARAMeasurementTool.toolName
            ) as DARAMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default DARA annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default DARA annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] DARA tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating DARA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用髋臼水平角测量工具
   */
  static deactivateDARAMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] DARA tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating DARA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查髋臼水平角测量工具是否处于激活状态
   */
  static isDARAMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === DARAMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking DARA tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换髋臼水平角测量工具状态
   */
  static toggleDARAMeasurementTool(viewportId: string): boolean {
    const isActive = this.isDARAMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateDARAMeasurementTool(viewportId);
    } else {
      return this.activateDARAMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有髋臼水平角测量标注
   */
  static clearDARAMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        DARAMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} DARA measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing DARA measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有髋臼水平角测量结果
   */
  // eslint-disable-next-line
  static getDARAMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        DARAMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        angleLeft: annotation.data?.cachedStats?.angleLeft || 0,
        angleRight: annotation.data?.cachedStats?.angleRight || 0,
        unit: 'degrees',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting DARA measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活髋臼水平角测量工具
   */
  static activateDARAMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateDARAMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用髋臼水平角测量工具
   */
  static deactivateDARAMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateDARAMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除髋臼水平角测量
   */
  static clearDARAMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearDARAMeasurements(viewportId)
    );
  }

  // ==================== 髋关节牵引指数测量工具 ====================

  /**
   * 激活髋关节牵引指数测量工具
   */
  static activateHipDIMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });

      // 激活髋关节牵引指数测量工具
      toolGroup.setToolActive(HipDIMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        HipDIMeasurementTool.toolName
      ) as HipDIMeasurementTool;

      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = HipDIMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              HipDIMeasurementTool.toolName
            ) as HipDIMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default HipDI annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default HipDI annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] HipDI tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating HipDI tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用髋关节牵引指数测量工具
   */
  static deactivateHipDIMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] HipDI tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating HipDI tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查髋关节牵引指数测量工具是否处于激活状态
   */
  static isHipDIMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === HipDIMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking HipDI tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换髋关节牵引指数测量工具状态
   */
  static toggleHipDIMeasurementTool(viewportId: string): boolean {
    const isActive = this.isHipDIMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateHipDIMeasurementTool(viewportId);
    } else {
      return this.activateHipDIMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有髋关节牵引指数测量标注
   */
  static clearHipDIMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipDIMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} HipDI measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing HipDI measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有髋关节牵引指数测量结果
   */
  // eslint-disable-next-line
  static getHipDIMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipDIMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        DI: annotation.data?.cachedStats?.DI || 0,
        distance: annotation.data?.cachedStats?.distance || 0,
        unit: 'ratio',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting HipDI measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活髋关节牵引指数测量工具
   */
  static activateHipDIMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateHipDIMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用髋关节牵引指数测量工具
   */
  static deactivateHipDIMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateHipDIMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除髋关节牵引指数测量
   */
  static clearHipDIMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearHipDIMeasurements(viewportId)
    );
  }

  // ==================== 髋关节水平角测量工具 ====================

  /**
   * 激活髋关节水平角测量工具
   */
  static activateHipNHAAngleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, {
        removeAllBindings: true,
      });

      // 激活髋关节水平角测量工具
      toolGroup.setToolActive(HipNHAAngleMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        HipNHAAngleMeasurementTool.toolName
      ) as HipNHAAngleMeasurementTool;

      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = HipNHAAngleMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              HipNHAAngleMeasurementTool.toolName
            ) as HipNHAAngleMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default HipNHA annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default HipNHA annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] HipNHA tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating HipNHA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用髋关节水平角测量工具
   */
  static deactivateHipNHAAngleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] HipNHA tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating HipNHA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查髋关节水平角测量工具是否处于激活状态
   */
  static isHipNHAAngleMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === HipNHAAngleMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking HipNHA tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换髋关节水平角测量工具状态
   */
  static toggleHipNHAAngleMeasurementTool(viewportId: string): boolean {
    const isActive = this.isHipNHAAngleMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateHipNHAAngleMeasurementTool(viewportId);
    } else {
      return this.activateHipNHAAngleMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有髋关节水平角测量标注
   */
  static clearHipNHAAngleMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipNHAAngleMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} HipNHA measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing HipNHA measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有髋关节水平角测量结果
   */
  // eslint-disable-next-line
  static getHipNHAAngleMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipNHAAngleMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        angleLeft: annotation.data?.cachedStats?.angleLeft || 0,
        angleRight: annotation.data?.cachedStats?.angleRight || 0,
        unit: 'degrees',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting HipNHA measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活髋关节水平角测量工具
   */
  static activateHipNHAAngleMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateHipNHAAngleMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用髋关节水平角测量工具
   */
  static deactivateHipNHAAngleMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateHipNHAAngleMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除髋关节水平角测量
   */
  static clearHipNHAAngleMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearHipNHAAngleMeasurements(viewportId)
    );
  }

  // ==================== 心锥比测量工具 ====================

  /**
   * 激活心锥比测量工具
   */
  static activateVHSMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, {
        removeAllBindings: true,
      });

      // 激活心锥比测量工具
      toolGroup.setToolActive(VHSMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        VHSMeasurementTool.toolName
      ) as VHSMeasurementTool;

      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = VHSMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              VHSMeasurementTool.toolName
            ) as VHSMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default VHS annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default VHS annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] VHS tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating VHS tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用心锥比测量工具
   */
  static deactivateVHSMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] VHS tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating VHS tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查心锥比测量工具是否处于激活状态
   */
  static isVHSMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === VHSMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking VHS tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换心锥比测量工具状态
   */
  static toggleVHSMeasurementTool(viewportId: string): boolean {
    const isActive = this.isVHSMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateVHSMeasurementTool(viewportId);
    } else {
      return this.activateVHSMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有心锥比测量标注
   */
  static clearVHSMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        VHSMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} VHS measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing VHS measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有心锥比测量结果
   */
  // eslint-disable-next-line
  static getVHSMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        VHSMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        vhs: annotation.data?.cachedStats?.vhs || 0,
        longAxisCount: annotation.data?.cachedStats?.longAxisCount || 0,
        shortAxisCount: annotation.data?.cachedStats?.shortAxisCount || 0,
        ratio: annotation.data?.cachedStats?.ratio || 0,
        unit: 'ratio',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting VHS measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活心锥比测量工具
   */
  static activateVHSMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateVHSMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用心锥比测量工具
   */
  static deactivateVHSMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateVHSMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除心锥比测量
   */
  static clearVHSMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearVHSMeasurements(viewportId)
    );
  }

  // ==================== TPLO测量工具 ====================

  /**
   * 激活TPLO测量工具
   */
  static activateTPLOMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, {
        removeAllBindings: true,
      });

      // 激活TPLO测量工具
      toolGroup.setToolActive(TPLOMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        TPLOMeasurementTool.toolName
      ) as TPLOMeasurementTool;

      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = TPLOMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              TPLOMeasurementTool.toolName
            ) as TPLOMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default TPLO annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default TPLO annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] TPLO tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating TPLO tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用TPLO测量工具
   */
  static deactivateTPLOMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] TPLO tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating TPLO tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查TPLO测量工具是否处于激活状态
   */
  static isTPLOMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === TPLOMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking TPLO tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换TPLO测量工具状态
   */
  static toggleTPLOMeasurementTool(viewportId: string): boolean {
    const isActive = this.isTPLOMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateTPLOMeasurementTool(viewportId);
    } else {
      return this.activateTPLOMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有TPLO测量标注
   */
  static clearTPLOMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TPLOMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} TPLO measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing TPLO measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有TPLO测量结果
   */
  // eslint-disable-next-line
  static getTPLOMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TPLOMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        tpa: annotation.data?.cachedStats?.tpa || 0,
        sawRadiusPx: annotation.data?.cachedStats?.sawRadiusPx || 0,
        sawRadiusMm: annotation.data?.cachedStats?.sawRadiusMm || 0,
        unit: 'mixed',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting TPLO measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活TPLO测量工具
   */
  static activateTPLOMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateTPLOMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用TPLO测量工具
   */
  static deactivateTPLOMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateTPLOMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除TPLO测量
   */
  static clearTPLOMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearTPLOMeasurements(viewportId)
    );
  }

  // ==================== TTA测量工具 ====================

  /**
   * 激活TTA测量工具
   */
  static activateTTAMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(MagnifyTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(LengthTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(AngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, {
        removeAllBindings: true,
      });

      // 激活TTA测量工具
      toolGroup.setToolActive(TTAMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(
        TTAMeasurementTool.toolName
      ) as TTAMeasurementTool;

      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          // 创建预设注解
          const defaultAnnotation = TTAMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          // 添加注解到状态管理
          cornerstoneTools.annotation.state.addAnnotation(
            defaultAnnotation,
            viewport.element
          );

          // 获取工具实例并更新缓存统计数据
          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(
              TTAMeasurementTool.toolName
            ) as TTAMeasurementTool;

            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
          viewport.render();

          console.log('[MeasurementToolManager] Default TTA annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default TTA annotation:', error);
        // 注解创建失败不影响工具激活
      }

      console.log(
        `[MeasurementToolManager] TTA tool activated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error activating TTA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 停用TTA测量工具
   */
  static deactivateTTAMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, {
        removeAllBindings: true,
      });
      console.log(
        `[MeasurementToolManager] TTA tool deactivated for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error deactivating TTA tool:`,
        error
      );
      return false;
    }
  }

  /**
   * 检查TTA测量工具是否处于激活状态
   */
  static isTTAMeasurementToolActive(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      const activeTool = toolGroup.getActivePrimaryMouseButtonTool();
      return activeTool === TTAMeasurementTool.toolName;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error checking TTA tool state:`,
        error
      );
      return false;
    }
  }

  /**
   * 切换TTA测量工具状态
   */
  static toggleTTAMeasurementTool(viewportId: string): boolean {
    const isActive = this.isTTAMeasurementToolActive(viewportId);

    if (isActive) {
      return this.deactivateTTAMeasurementTool(viewportId);
    } else {
      return this.activateTTAMeasurementTool(viewportId);
    }
  }

  /**
   * 清除指定 viewport 的所有TTA测量标注
   */
  static clearTTAMeasurements(viewportId: string): boolean {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return false;
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TTAMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(
            annotation.annotationUID
          );
          removedCount++;
        }
      });

      viewport.render();
      console.log(
        `[MeasurementToolManager] Cleared ${removedCount} TTA measurements for viewport: ${viewportId}`
      );
      return true;
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error clearing TTA measurements:`,
        error
      );
      return false;
    }
  }

  /**
   * 获取指定 viewport 的所有TTA测量结果
   */
  // eslint-disable-next-line
  static getTTAMeasurements(viewportId: string): any[] {
    try {
      const viewport =
        cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) {
        console.warn(
          `[MeasurementToolManager] Viewport not found: ${viewportId}`
        );
        return [];
      }

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        TTAMeasurementTool.toolName,
        viewport.element
      );

      return annotations.map((annotation) => ({
        annotationUID: annotation.annotationUID,
        ttaDistance: annotation.data?.cachedStats?.ttaDistance || 0,
        unit: 'mm',
        points: annotation.data?.handles?.points || [],
      }));
    } catch (error) {
      console.error(
        `[MeasurementToolManager] Error getting TTA measurements:`,
        error
      );
      return [];
    }
  }

  /**
   * 为多个 viewport 批量激活TTA测量工具
   */
  static activateTTAMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.activateTTAMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量停用TTA测量工具
   */
  static deactivateTTAMeasurementToolForViewports(
    viewportIds: string[]
  ): boolean[] {
    return viewportIds.map((viewportId) =>
      this.deactivateTTAMeasurementTool(viewportId)
    );
  }

  /**
   * 为多个 viewport 批量清除TTA测量
   */
  static clearTTAMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) =>
      this.clearTTAMeasurements(viewportId)
    );
  }

  // ==================== CBLO(水平截骨术)测量工具 ====================

  /**
   * 激活CBLO测量工具
   */
  static activateCBLOMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(CBLOMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(CBLOMeasurementTool.toolName) as CBLOMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = CBLOMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(CBLOMeasurementTool.toolName) as CBLOMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          viewport.render();
          console.log('[MeasurementToolManager] Default CBLO annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default CBLO annotation:', error);
      }

      console.log(`[MeasurementToolManager] CBLO tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating CBLO tool:`, error);
      return false;
    }
  }

  static deactivateCBLOMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] CBLO tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating CBLO tool:`, error);
      return false;
    }
  }

  static clearCBLOMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        CBLOMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} CBLO measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing CBLO measurements:`, error);
      return false;
    }
  }

  static clearCBLOMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearCBLOMeasurements(viewportId));
  }

  // ==================== HipCoverage(股骨头覆盖率)测量工具 ====================

  static activateHipCoverageMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(HipCoverageMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(HipCoverageMeasurementTool.toolName) as HipCoverageMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = HipCoverageMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(HipCoverageMeasurementTool.toolName) as HipCoverageMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          viewport.render();
          console.log('[MeasurementToolManager] Default HipCoverage annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default HipCoverage annotation:', error);
      }

      console.log(`[MeasurementToolManager] HipCoverage tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating HipCoverage tool:`, error);
      return false;
    }
  }

  static deactivateHipCoverageMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] HipCoverage tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating HipCoverage tool:`, error);
      return false;
    }
  }

  static clearHipCoverageMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipCoverageMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} HipCoverage measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing HipCoverage measurements:`, error);
      return false;
    }
  }

  static clearHipCoverageMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearHipCoverageMeasurements(viewportId));
  }

  // ==================== HipDorsalCoverage(髋臼背覆盖)测量工具 ====================

  static activateHipDorsalCoverageTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(HipDorsalCoverageTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(HipDorsalCoverageTool.toolName) as HipDorsalCoverageTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = HipDorsalCoverageTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(HipDorsalCoverageTool.toolName) as HipDorsalCoverageTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          viewport.render();
          console.log('[MeasurementToolManager] Default HipDorsalCoverage annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default HipDorsalCoverage annotation:', error);
      }

      console.log(`[MeasurementToolManager] HipDorsalCoverage tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating HipDorsalCoverage tool:`, error);
      return false;
    }
  }

  static deactivateHipDorsalCoverageTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] HipDorsalCoverage tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating HipDorsalCoverage tool:`, error);
      return false;
    }
  }

  static clearHipDorsalCoverageMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HipDorsalCoverageTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} HipDorsalCoverage measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing HipDorsalCoverage measurements:`, error);
      return false;
    }
  }

  static clearHipDorsalCoverageMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearHipDorsalCoverageMeasurements(viewportId));
  }

  // ==================== CircleCenter(找圆心)测量工具 ====================

  static activateCircleCenterMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(CircleCenterMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(CircleCenterMeasurementTool.toolName) as CircleCenterMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = CircleCenterMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(CircleCenterMeasurementTool.toolName) as CircleCenterMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          // 触发渲染更新
viewport.render();

          console.log('[MeasurementToolManager] Default CircleCenter annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default CircleCenter annotation:', error);
      }

      console.log(`[MeasurementToolManager] CircleCenter tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating CircleCenter tool:`, error);
      return false;
    }
  }

  static deactivateCircleCenterMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] CircleCenter tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating CircleCenter tool:`, error);
      return false;
    }
  }

  static clearCircleCenterMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        CircleCenterMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} CircleCenter measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing CircleCenter measurements:`, error);
      return false;
    }
  }

  static clearCircleCenterMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearCircleCenterMeasurements(viewportId));
  }

  // ==================== Midline(找中线)测量工具 ====================

  static activateMidlineMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(MidlineMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(MidlineMeasurementTool.toolName) as MidlineMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = MidlineMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(MidlineMeasurementTool.toolName) as MidlineMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          const viewportIdsToRender = cornerstoneTools.utilities.viewportFilters.getViewportIdsWithToolToRender(
            viewport.element,
            MidlineMeasurementTool.toolName
          );

          cornerstoneTools.utilities.triggerAnnotationRenderForViewportIds(
            viewportIdsToRender
          );

          console.log('[MeasurementToolManager] Default Midline annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default Midline annotation:', error);
      }

      console.log(`[MeasurementToolManager] Midline tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating Midline tool:`, error);
      return false;
    }
  }

  static deactivateMidlineMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] Midline tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating Midline tool:`, error);
      return false;
    }
  }

  static clearMidlineMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        MidlineMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} Midline measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing Midline measurements:`, error);
      return false;
    }
  }

  static clearMidlineMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearMidlineMeasurements(viewportId));
  }

  // ==================== FindMidpoint(找中点)测量工具 ====================

  static activateFindMidpointMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(FindMidpointMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(FindMidpointMeasurementTool.toolName) as FindMidpointMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = FindMidpointMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(FindMidpointMeasurementTool.toolName) as FindMidpointMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          const viewportIdsToRender = cornerstoneTools.utilities.viewportFilters.getViewportIdsWithToolToRender(
            viewport.element,
            FindMidpointMeasurementTool.toolName
          );

          cornerstoneTools.utilities.triggerAnnotationRenderForViewportIds(
            viewportIdsToRender
          );

          console.log('[MeasurementToolManager] Default FindMidpoint annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default FindMidpoint annotation:', error);
      }

      console.log(`[MeasurementToolManager] FindMidpoint tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating FindMidpoint tool:`, error);
      return false;
    }
  }

  static deactivateFindMidpointMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] FindMidpoint tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating FindMidpoint tool:`, error);
      return false;
    }
  }

  static clearFindMidpointMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        FindMidpointMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} FindMidpoint measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing FindMidpoint measurements:`, error);
      return false;
    }
  }

  static clearFindMidpointMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearFindMidpointMeasurements(viewportId));
  }

  // ==================== VerticalTilt(直线垂直倾斜度)测量工具 ====================

  static activateVerticalTiltMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(VerticalTiltMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(VerticalTiltMeasurementTool.toolName) as VerticalTiltMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = VerticalTiltMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(VerticalTiltMeasurementTool.toolName) as VerticalTiltMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          const viewportIdsToRender = cornerstoneTools.utilities.viewportFilters.getViewportIdsWithToolToRender(
            viewport.element,
            VerticalTiltMeasurementTool.toolName
          );

          cornerstoneTools.utilities.triggerAnnotationRenderForViewportIds(
            viewportIdsToRender
          );

          console.log('[MeasurementToolManager] Default VerticalTilt annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default VerticalTilt annotation:', error);
      }

      console.log(`[MeasurementToolManager] VerticalTilt tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating VerticalTilt tool:`, error);
      return false;
    }
  }

  static deactivateVerticalTiltMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] VerticalTilt tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating VerticalTilt tool:`, error);
      return false;
    }
  }

  static clearVerticalTiltMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        VerticalTiltMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} VerticalTilt measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing VerticalTilt measurements:`, error);
      return false;
    }
  }

  static clearVerticalTiltMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearVerticalTiltMeasurements(viewportId));
  }

  // ==================== HorizontalTilt(直线水平倾斜度)测量工具 ====================

  static activateHorizontalTiltMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });

      toolGroup.setToolActive(HorizontalTiltMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      const toolInstance = toolGroup.getToolInstance(HorizontalTiltMeasurementTool.toolName) as HorizontalTiltMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = HorizontalTiltMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(HorizontalTiltMeasurementTool.toolName) as HorizontalTiltMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          const viewportIdsToRender = cornerstoneTools.utilities.viewportFilters.getViewportIdsWithToolToRender(
            viewport.element,
            HorizontalTiltMeasurementTool.toolName
          );

          cornerstoneTools.utilities.triggerAnnotationRenderForViewportIds(
            viewportIdsToRender
          );

          console.log('[MeasurementToolManager] Default HorizontalTilt annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default HorizontalTilt annotation:', error);
      }

      console.log(`[MeasurementToolManager] HorizontalTilt tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating HorizontalTilt tool:`, error);
      return false;
    }
  }

  static deactivateHorizontalTiltMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(HorizontalTiltMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] HorizontalTilt tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating HorizontalTilt tool:`, error);
      return false;
    }
  }

  static clearHorizontalTiltMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        HorizontalTiltMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} HorizontalTilt measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing HorizontalTilt measurements:`, error);
      return false;
    }
  }

  static clearHorizontalTiltMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearHorizontalTiltMeasurements(viewportId));
  }

  // ==================== PolygonLengthMeasurement(多边形长度测量)工具 ====================

  /**
   * 激活多边形长度测量工具
   */
  static activatePolygonLengthMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HorizontalTiltMeasurementTool.toolName, { removeAllBindings: true });

      // 激活多边形长度测量工具
      toolGroup.setToolActive(PolygonLengthMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活绘制模式（因为多边形工具是绘制类型的）
      const toolInstance = toolGroup.getToolInstance(PolygonLengthMeasurementTool.toolName) as PolygonLengthMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateDraw(viewport.element);
      }

      console.log(`[MeasurementToolManager] PolygonLengthMeasurement tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating PolygonLengthMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 停用多边形长度测量工具
   */
  static deactivatePolygonLengthMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(PolygonLengthMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] PolygonLengthMeasurement tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating PolygonLengthMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 清除指定 viewport 的所有多边形长度测量标注
   */
  static clearPolygonLengthMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        PolygonLengthMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} PolygonLength measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing PolygonLength measurements:`, error);
      return false;
    }
  }

  static clearPolygonLengthMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearPolygonLengthMeasurements(viewportId));
  }

  // ==================== PolylineLengthMeasurement(拆线长度测量)工具 ====================

  /**
   * 激活拆线长度测量工具
   */
  static activatePolylineLengthMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HorizontalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(PolygonLengthMeasurementTool.toolName, { removeAllBindings: true });

      // 激活拆线长度测量工具
      toolGroup.setToolActive(PolylineLengthMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活绘制模式（因为折线工具是绘制类型的）
      const toolInstance = toolGroup.getToolInstance(PolylineLengthMeasurementTool.toolName) as PolylineLengthMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateDraw(viewport.element);
      }

      console.log(`[MeasurementToolManager] PolylineLengthMeasurement tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating PolylineLengthMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 停用拆线长度测量工具
   */
  static deactivatePolylineLengthMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(PolylineLengthMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] PolylineLengthMeasurement tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating PolylineLengthMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 清除指定 viewport 的所有拆线长度测量标注
   */
  static clearPolylineLengthMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        PolylineLengthMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} PolylineLength measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing PolylineLength measurements:`, error);
      return false;
    }
  }

  static clearPolylineLengthMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearPolylineLengthMeasurements(viewportId));
  }

  // ==================== LineGrayscaleMeasurement(直线灰度测量)工具 ====================

  /**
   * 激活直线灰度测量工具
   */
  static activateLineGrayscaleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HorizontalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(PolygonLengthMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(PolylineLengthMeasurementTool.toolName, { removeAllBindings: true });

      // 激活直线灰度测量工具
      toolGroup.setToolActive(LineGrayscaleMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(LineGrayscaleMeasurementTool.toolName) as LineGrayscaleMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = LineGrayscaleMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(LineGrayscaleMeasurementTool.toolName) as LineGrayscaleMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          viewport.render();
          console.log('[MeasurementToolManager] Default LineGrayscale annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default LineGrayscale annotation:', error);
      }

      console.log(`[MeasurementToolManager] LineGrayscaleMeasurement tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating LineGrayscaleMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 停用直线灰度测量工具
   */
  static deactivateLineGrayscaleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(LineGrayscaleMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] LineGrayscaleMeasurement tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating LineGrayscaleMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 清除指定 viewport 的所有直线灰度测量标注
   */
  static clearLineGrayscaleMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        LineGrayscaleMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} LineGrayscale measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing LineGrayscale measurements:`, error);
      return false;
    }
  }

  /**
   * 为多个 viewport 批量清除直线灰度测量
   */
  static clearLineGrayscaleMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearLineGrayscaleMeasurements(viewportId));
  }

  // ==================== RectangleGrayscaleMeasurement(矩形区域灰度测量)工具 ====================

  /**
   * 激活矩形区域灰度测量工具
   */
  static activateRectangleGrayscaleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      // 停用其他可能冲突的工具
      toolGroup.setToolPassive(WindowLevelTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MagnifyTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LengthTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(AngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TibialPlateauAngleTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(DARAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDIMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipNHAAngleMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VHSMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TPLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(TTAMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CBLOMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipCoverageMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HipDorsalCoverageTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(CircleCenterMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(MidlineMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(FindMidpointMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(VerticalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(HorizontalTiltMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(PolygonLengthMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(PolylineLengthMeasurementTool.toolName, { removeAllBindings: true });
      toolGroup.setToolPassive(LineGrayscaleMeasurementTool.toolName, { removeAllBindings: true });

      // 激活矩形区域灰度测量工具
      toolGroup.setToolActive(RectangleGrayscaleMeasurementTool.toolName, {
        bindings: [{ mouseButton: MouseBindings.Primary }],
      });

      // 获取工具实例并激活修改模式
      const toolInstance = toolGroup.getToolInstance(RectangleGrayscaleMeasurementTool.toolName) as RectangleGrayscaleMeasurementTool;
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (toolInstance && viewport.element) {
        toolInstance._activateModify(viewport.element);
      }

      // 自动创建一个预设的注解
      try {
        if (viewport && viewport.element) {
          const defaultAnnotation = RectangleGrayscaleMeasurementTool.createDefaultAnnotation(
            viewport.element as HTMLDivElement,
            viewport as cornerstone.Types.IStackViewport
          );

          cornerstoneTools.annotation.state.addAnnotation(defaultAnnotation, viewport.element);

          const enabledElement = cornerstone.getEnabledElement(viewport.element);
          if (enabledElement) {
            const toolInstance = toolGroup.getToolInstance(RectangleGrayscaleMeasurementTool.toolName) as RectangleGrayscaleMeasurementTool;
            if (toolInstance && '_updateCachedStats' in toolInstance) {
              (toolInstance as any)._updateCachedStats(defaultAnnotation, enabledElement);
            }
          }

          viewport.render();
          console.log('[MeasurementToolManager] Default RectangleGrayscale annotation created successfully');
        }
      } catch (error) {
        console.error('[MeasurementToolManager] Failed to create default RectangleGrayscale annotation:', error);
      }

      console.log(`[MeasurementToolManager] RectangleGrayscaleMeasurement tool activated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error activating RectangleGrayscaleMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 停用矩形区域灰度测量工具
   */
  static deactivateRectangleGrayscaleMeasurementTool(viewportId: string): boolean {
    const toolGroup = MeasurementToolManager.getToolGroup(viewportId);
    if (!toolGroup) return false;

    try {
      toolGroup.setToolPassive(RectangleGrayscaleMeasurementTool.toolName, { removeAllBindings: true });
      console.log(`[MeasurementToolManager] RectangleGrayscaleMeasurement tool deactivated for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error deactivating RectangleGrayscaleMeasurement tool:`, error);
      return false;
    }
  }

  /**
   * 清除指定 viewport 的所有矩形区域灰度测量标注
   */
  static clearRectangleGrayscaleMeasurements(viewportId: string): boolean {
    try {
      const viewport = cornerstone.getEnabledElementByViewportId(viewportId)?.viewport;
      if (!viewport) return false;

      const annotations = cornerstoneTools.annotation.state.getAnnotations(
        RectangleGrayscaleMeasurementTool.toolName,
        viewport.element
      );

      let removedCount = 0;
      annotations.forEach((annotation) => {
        if (annotation.annotationUID) {
          cornerstoneTools.annotation.state.removeAnnotation(annotation.annotationUID);
          removedCount++;
        }
      });

      viewport.render();
      console.log(`[MeasurementToolManager] Cleared ${removedCount} RectangleGrayscale measurements for viewport: ${viewportId}`);
      return true;
    } catch (error) {
      console.error(`[MeasurementToolManager] Error clearing RectangleGrayscale measurements:`, error);
      return false;
    }
  }

  /**
   * 为多个 viewport 批量清除矩形区域灰度测量
   */
  static clearRectangleGrayscaleMeasurementsForViewports(viewportIds: string[]): boolean[] {
    return viewportIds.map((viewportId) => this.clearRectangleGrayscaleMeasurements(viewportId));
  }
}