{
  "ptid_time": "141_S_4438_2013-01-28",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4438/2013-01-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 97,478 mm³, 153.1% above the reference mean. With a Z-score of 3.67 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 8,252 mm³, 9.2% above the reference mean. With a Z-score of 0.89 (81.4th percentile), this represents normal volume ; whole brain volume measures 1,182,340 mm³, 9.5% above the reference mean. With a Z-score of 1.24 (89.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,486 mm³, 9.4% above the reference mean. With a Z-score of 0.64 (73.8th percentile), this represents normal volume ; fusiform gyrus volume measures 21,236 mm³, 12.7% above the reference mean. With a Z-score of 1.08 (86.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 25,520 mm³, 19.6% above the reference mean. With a Z-score of 1.76 (96.1th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 77.8 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 26.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is profoundly enlarged (Z-score 3.67), which is highly suggestive of significant atrophy, but hippocampal, entorhinal cortex, and other key regions are normal or even enlarged. Cognitive scores (MMSE 29, MoCA 26) are within normal limits, and there is no APOE4 risk allele. The ventricular enlargement may reflect non-Alzheimer's pathology (e.g., normal pressure hydrocephalus or generalized atrophy).  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (ventricular enlargement is concerning, but cognitive performance and other structural measures do not support MCI or dementia)",
  "timestamp": "2025-07-26T17:04:23.083798"
}