{
  "ptid_time": "032_S_0479_2012-09-17",
  "img_path": "/data/qiuhui/data/adni/images/032_S_0479/2012-09-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,549 mm³, 97.9% above the reference mean. With a Z-score of 2.24 (98.8th percentile), this represents significant enlargement; hippocampal volume measures 6,681 mm³, 6.1% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume ; whole brain volume measures 970,410 mm³, 0.4% below the reference mean. With a Z-score of -0.05 (47.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,313 mm³, 37.0% below the reference mean. With a Z-score of -2.27 (1.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,689 mm³, 19.5% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,756 mm³, 7.4% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume . ",
  "text_data": "Age is 79.5 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement and marked atrophy in the entorhinal cortex and fusiform gyrus, which are key regions affected in Alzheimer's disease. However, cognitive scores (MMSE 30, MoCA 26) are within normal limits, and hippocampal volume is preserved, suggesting no significant functional impairment yet.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to entorhinal atrophy, but cognitive scores are borderline normal).  \n\n**Confidence:** **Medium** (structural changes are concerning, but cognitive performance does not yet meet dementia criteria; APOE4-negative status reduces but doesn't exclude AD risk).  \n\n*Note: Follow-up clinical correlation (e.g., neuropsychological testing for subtle memory deficits) and biomarker testing (CSF Aβ/tau or PET) would strengthen confidence.*",
  "timestamp": "2025-07-26T04:55:58.427614"
}