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This paper discusses the security problem of integrality and reality authentication in medical image, and introduces digital signature technology based on RSA public cryptosystem in brief. It analyzes the merit and insufficiency of digital signature technology. Considering the specialty of medical image, it brings forward integrating reversible digital watermarking with digital signature to form an authentication system. Then, the scheme of the system is carried through. Finally, the system is designed and implemented by using the c# software. The experiment results show that the proposed system has good imperceptibility. It effectively solves the problem of complete integrity and reality authentication of medical image.