{
  "ptid_time": "136_S_0299_2006-11-08",
  "img_path": "/data/qiuhui/data/adni/images/136_S_0299/2006-11-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,138 mm³, 32.9% above the reference mean. With a Z-score of 0.89 (81.3th percentile), this represents normal volume ; hippocampal volume measures 6,270 mm³, 3.5% below the reference mean. With a Z-score of -0.28 (39.1th percentile), this represents normal volume ; whole brain volume measures 844,876 mm³, 9.0% below the reference mean. With a Z-score of -1.08 (14.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,501 mm³, 30.0% above the reference mean. With a Z-score of 1.62 (94.7th percentile), this represents moderate enlargement; fusiform gyrus volume measures 16,762 mm³, 4.0% above the reference mean. With a Z-score of 0.30 (62.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,939 mm³, 11.6% below the reference mean. With a Z-score of -1.03 (15.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 89.6 years. Gender is Female. Education: 20 years. MMSE: 27.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild atrophy in the whole brain and middle temporal gyrus, but hippocampal volume is normal. The MMSE score of 27 is within the normal range (≥26), and there is no APOE4 genetic risk factor. Given the absence of significant cognitive impairment despite mild atrophy, this likely reflects age-related changes rather than dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild atrophy in some regions but preserved cognitive function)",
  "timestamp": "2025-07-26T16:00:19.609271"
}