{
  "ptid_time": "021_S_0984_2007-06-29",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0984/2007-06-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 80,190 mm³, 108.2% above the reference mean. With a Z-score of 2.59 (99.5th percentile), this represents significant enlargement; hippocampal volume measures 7,716 mm³, 2.1% above the reference mean. With a Z-score of 0.20 (58.0th percentile), this represents normal volume ; whole brain volume measures 1,095,450 mm³, 1.5% above the reference mean. With a Z-score of 0.19 (57.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,714 mm³, 9.4% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume ; fusiform gyrus volume measures 18,993 mm³, 0.8% above the reference mean. With a Z-score of 0.07 (52.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,205 mm³, 8.7% above the reference mean. With a Z-score of 0.79 (78.4th percentile), this represents normal volume . ",
  "text_data": "Age is 77.1 years. Gender is Male. Education: 14 years. MMSE: 30.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is significantly enlarged (Z-score 2.59), which is a strong indicator of neurodegeneration, but hippocampal and whole brain volumes are normal. The MMSE score of 30 is intact, and there are no clear cognitive deficits reported. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to significant ventricular enlargement suggesting early neurodegeneration despite normal cognition)  \n**Confidence:** **Medium** (structural changes are concerning, but cognitive performance is intact, making definitive classification difficult without longitudinal data or biomarker confirmation).",
  "timestamp": "2025-07-26T01:35:22.682072"
}