{
  "ptid_time": "029_S_5219_2019-03-14",
  "img_path": "/data/qiuhui/data/adni/images/029_S_5219/2019-03-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,444 mm³, 65.0% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy; hippocampal volume measures 7,304 mm³, 4.8% above the reference mean. With a Z-score of 0.42 (66.1th percentile), this represents normal volume ; whole brain volume measures 1,139,040 mm³, 10.7% above the reference mean. With a Z-score of 1.40 (91.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,661 mm³, 7.8% below the reference mean. With a Z-score of -0.51 (30.6th percentile), this represents normal volume ; fusiform gyrus volume measures 19,344 mm³, 7.1% above the reference mean. With a Z-score of 0.61 (73.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,826 mm³, 18.1% above the reference mean. With a Z-score of 1.62 (94.8th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 81.2 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 18.0. Logical Memory: 7.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular atrophy (Z-score -1.89) and a normal hippocampal volume (Z-score 0.42), which is atypical for Alzheimer’s given the preserved hippocampus. However, the MoCA score of 18 suggests significant cognitive impairment, while the MMSE of 28 is incongruently high, raising concerns about test reliability or possible non-AD pathology (e.g., vascular or mixed dementia). The APOE4 carrier status increases AD risk but isn’t definitive.  \n\n**Diagnosis:** **Dementia** (likely mixed etiology, given discordant imaging and cognitive scores).  \n**Confidence:** **Medium** (due to conflicting biomarkers and cognitive test results).",
  "timestamp": "2025-07-26T04:33:23.506692"
}