{
  "ptid_time": "032_S_0479_2006-11-27",
  "img_path": "/data/qiuhui/data/adni/images/032_S_0479/2006-11-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,869 mm³, 17.1% above the reference mean. With a Z-score of 0.39 (65.2th percentile), this represents normal volume ; hippocampal volume measures 7,736 mm³, 8.7% above the reference mean. With a Z-score of 0.80 (78.8th percentile), this represents normal volume ; whole brain volume measures 1,063,320 mm³, 9.1% above the reference mean. With a Z-score of 1.15 (87.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,871 mm³, 21.8% below the reference mean. With a Z-score of -1.34 (9.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,768 mm³, 13.2% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 21,097 mm³, 10.1% above the reference mean. With a Z-score of 0.87 (80.9th percentile), this represents normal volume . ",
  "text_data": "Age is 74.0 years. Gender is Female. Education: 20 years. MMSE: 30.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex and fusiform gyrus show mild atrophy (Z-scores -1.34 and -1.20, respectively), which are early markers of Alzheimer's pathology. However, hippocampal and whole brain volumes are normal or enlarged, and MMSE is intact (30/30), suggesting no significant cognitive impairment.  \n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting structural findings—atrophy in key regions but preserved cognition and other volumes)",
  "timestamp": "2025-07-26T04:55:13.855489"
}