{
  "ptid_time": "041_S_0282_2006-04-19",
  "img_path": "/data/qiuhui/data/adni/images/041_S_0282/2006-04-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,099 mm³, 55.6% below the reference mean. With a Z-score of -1.33 (9.1th percentile), this represents mild atrophy; hippocampal volume measures 7,892 mm³, 4.4% above the reference mean. With a Z-score of 0.43 (66.6th percentile), this represents normal volume ; whole brain volume measures 890,243 mm³, 17.5% below the reference mean. With a Z-score of -2.27 (1.1th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,970 mm³, 3.2% below the reference mean. With a Z-score of -0.22 (41.5th percentile), this represents normal volume ; fusiform gyrus volume measures 17,712 mm³, 6.0% below the reference mean. With a Z-score of -0.51 (30.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,537 mm³, 22.5% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 72.1 years. Gender is Male. Education: 20 years. MMSE: 28.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant whole-brain atrophy (Z-score -2.27, 1.1th percentile) and middle temporal gyrus atrophy (Z-score -2.02, 2.2th percentile), which are concerning for neurodegenerative changes. However, hippocampal and entorhinal cortex volumes are within normal ranges, and the MMSE score of 28 is intact, suggesting no significant cognitive impairment.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Structural atrophy is present, but cognitive performance remains intact, and APOE4-negative status reduces Alzheimer’s risk. Follow-up monitoring is warranted.)",
  "timestamp": "2025-07-26T06:56:51.722839"
}