{
  "ptid_time": "022_S_4291_2013-01-30",
  "img_path": "/data/qiuhui/data/adni/images/022_S_4291/2013-01-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 64,539 mm³, 129.9% above the reference mean. With a Z-score of 2.98 (99.9th percentile), this represents significant enlargement; hippocampal volume measures 6,615 mm³, 7.0% below the reference mean. With a Z-score of -0.64 (26.0th percentile), this represents normal volume ; whole brain volume measures 911,961 mm³, 6.4% below the reference mean. With a Z-score of -0.81 (20.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,464 mm³, 5.7% below the reference mean. With a Z-score of -0.35 (36.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,558 mm³, 2.7% below the reference mean. With a Z-score of -0.24 (40.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,724 mm³, 7.5% below the reference mean. With a Z-score of -0.65 (25.6th percentile), this represents normal volume . ",
  "text_data": "Age is 76.5 years. Gender is Female. Education: 20 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.98), which is a marker of brain atrophy, but hippocampal and other regional volumes are within normal ranges (Z-scores close to 0). Cognitive scores (MMSE 29, MoCA 25) are borderline for MCI (MoCA <26 suggests possible impairment), but no APOE4 risk allele is present.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Ventricular enlargement and borderline MoCA suggest possible early decline, but other volumes and MMSE are normal, and APOE4 is absent.)",
  "timestamp": "2025-07-26T02:19:23.200204"
}