{
  "ptid_time": "128_S_2045_2011-10-25",
  "img_path": "/data/qiuhui/data/adni/images/128_S_2045/2011-10-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 87,216 mm³, 126.4% above the reference mean. With a Z-score of 3.03 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 7,736 mm³, 2.3% above the reference mean. With a Z-score of 0.23 (59.0th percentile), this represents normal volume ; whole brain volume measures 1,155,970 mm³, 7.1% above the reference mean. With a Z-score of 0.92 (82.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,762 mm³, 16.1% above the reference mean. With a Z-score of 1.09 (86.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 22,604 mm³, 20.0% above the reference mean. With a Z-score of 1.70 (95.6th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 23,214 mm³, 8.8% above the reference mean. With a Z-score of 0.79 (78.5th percentile), this represents normal volume . ",
  "text_data": "Age is 73.3 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Major Surgical Procedures. MMSE: 30.0. MoCA: 30.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.03), which is strongly associated with neurodegeneration, but hippocampal volume is normal (Z-score 0.23), and cognitive scores (MMSE/MoCA = 30) are intact. The APOE4 carrier status increases Alzheimer’s risk, but without cognitive deficits, this suggests preclinical or very early changes.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Structural changes are concerning, but cognitive performance remains unimpaired; longitudinal monitoring is warranted.)",
  "timestamp": "2025-07-26T13:58:41.192735"
}