{
  "ptid_time": "136_S_0873_2008-04-17",
  "img_path": "/data/qiuhui/data/adni/images/136_S_0873/2008-04-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,218 mm³, 25.5% above the reference mean. With a Z-score of 0.58 (72.0th percentile), this represents normal volume ; hippocampal volume measures 5,574 mm³, 21.7% below the reference mean. With a Z-score of -1.99 (2.4th percentile), this represents moderate atrophy; whole brain volume measures 829,867 mm³, 14.9% below the reference mean. With a Z-score of -1.87 (3.1th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,625 mm³, 28.5% below the reference mean. With a Z-score of -1.75 (4.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 11,978 mm³, 29.6% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,774 mm³, 12.5% below the reference mean. With a Z-score of -1.08 (13.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 79.6 years. Gender is Female. Education: 14 years. MMSE: 23.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus) alongside mild-moderate whole-brain atrophy. The MMSE score of 23 suggests cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy and APOE4 status).  \n\n**Confidence:** **High** (due to clear structural deficits in AD-vulnerable regions and corroborating cognitive decline).",
  "timestamp": "2025-07-26T16:04:10.193531"
}