{
  "ptid_time": "011_S_2274_2012-02-16",
  "img_path": "/data/qiuhui/data/adni/images/011_S_2274/2012-02-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 63,071 mm³, 110.1% above the reference mean. With a Z-score of 2.62 (99.6th percentile), this represents significant enlargement; hippocampal volume measures 6,747 mm³, 15.9% below the reference mean. With a Z-score of -1.59 (5.5th percentile), this represents moderate atrophy; whole brain volume measures 1,428,190 mm³, 25.9% above the reference mean. With a Z-score of 3.66 (100.0th percentile), this represents profound enlargement; entorhinal cortex volume measures 2,673 mm³, 37.3% below the reference mean. With a Z-score of -2.58 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 20,327 mm³, 2.1% above the reference mean. With a Z-score of 0.17 (56.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,275 mm³, 8.3% above the reference mean. With a Z-score of 0.68 (75.3th percentile), this represents normal volume . ",
  "text_data": "Age is 65.0 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Renal-Genitourinary; Smoking. MMSE: 27.0. MoCA: 28.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.62) and profound whole-brain enlargement (Z-score 3.66), which are atypical for typical Alzheimer's pathology. However, there is significant hippocampal (Z-score -1.59) and entorhinal cortex atrophy (Z-score -2.58), which are hallmarks of Alzheimer's disease. The cognitive scores (MMSE 27, MoCA 28) are within normal limits, suggesting preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to significant atrophy in memory-related regions but normal cognitive scores)  \n**Confidence:** **Medium** (atypical whole-brain enlargement complicates the interpretation, but hippocampal/entorhinal atrophy strongly suggests early neurodegeneration)",
  "timestamp": "2025-07-25T22:52:12.859346"
}