{
  "ptid_time": "082_S_0641_2006-06-19",
  "img_path": "/data/qiuhui/data/adni/images/082_S_0641/2006-06-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 103,298 mm³, 168.2% above the reference mean. With a Z-score of 4.03 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,233 mm³, 17.5% below the reference mean. With a Z-score of -1.71 (4.4th percentile), this represents moderate atrophy; whole brain volume measures 1,051,330 mm³, 2.6% below the reference mean. With a Z-score of -0.34 (36.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,361 mm³, 18.0% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,684 mm³, 16.7% below the reference mean. With a Z-score of -1.43 (7.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,661 mm³, 21.9% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 74.4 years. Gender is Male. Education: 14 years. MMSE: 28.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant ventricular enlargement (Z-score 4.03) and moderate hippocampal atrophy (Z-score -1.71), along with mild-to-moderate atrophy in other AD-vulnerable regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus). Despite a normal MMSE (28/30), the structural changes are concerning for neurodegeneration. APOE4 positivity (1 allele) increases AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (high likelihood of underlying Alzheimer’s pathology given the atrophy pattern and APOE4 status).  \n\n**Confidence:** **High** (imaging strongly supports neurodegeneration, though cognitive performance remains near-normal, fitting MCI criteria).  \n\n*Note: Follow-up cognitive testing (e.g., neuropsychological battery) and biomarkers (e.g., CSF Aβ/tau, PET) would help confirm etiology.*",
  "timestamp": "2025-07-26T09:58:11.182030"
}