{
  "ptid_time": "036_S_0976_2008-01-15",
  "img_path": "/data/qiuhui/data/adni/images/036_S_0976/2008-01-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,025 mm³, 2.1% below the reference mean. With a Z-score of -0.06 (47.6th percentile), this represents normal volume ; hippocampal volume measures 5,810 mm³, 16.6% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy; whole brain volume measures 842,367 mm³, 18.2% below the reference mean. With a Z-score of -2.38 (0.9th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,710 mm³, 31.7% below the reference mean. With a Z-score of -2.08 (1.9th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,242 mm³, 21.2% below the reference mean. With a Z-score of -1.83 (3.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,697 mm³, 17.2% below the reference mean. With a Z-score of -1.54 (6.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 81.5 years. Gender is Male. Education: 15 years. MMSE: 25.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The patient shows significant atrophy in whole brain volume and entorhinal cortex, along with moderate atrophy in the fusiform gyrus and middle temporal gyrus, and mild hippocampal atrophy. These findings, particularly in memory-related regions, alongside a borderline MMSE score (25/30) in an 81-year-old male, suggest cognitive impairment beyond normal aging. The absence of APOE4 reduces but does not eliminate Alzheimer's risk.  \nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (Clinical correlation needed; MMSE is borderline, and structural changes are concerning but not definitive for dementia).",
  "timestamp": "2025-07-26T06:07:53.184626"
}