{
  "ptid_time": "128_S_4553_2013-03-20",
  "img_path": "/data/qiuhui/data/adni/images/128_S_4553/2013-03-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,934 mm³, 24.2% below the reference mean. With a Z-score of -0.61 (27.2th percentile), this represents normal volume ; hippocampal volume measures 7,581 mm³, 1.3% below the reference mean. With a Z-score of -0.15 (44.0th percentile), this represents normal volume ; whole brain volume measures 1,123,450 mm³, 9.2% above the reference mean. With a Z-score of 1.14 (87.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,115 mm³, 20.0% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,788 mm³, 2.3% below the reference mean. With a Z-score of -0.26 (39.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,081 mm³, 2.7% above the reference mean. With a Z-score of 0.24 (59.6th percentile), this represents normal volume . ",
  "text_data": "Age is 69.5 years. Gender is Female. Education: 17 years. MMSE: 29.0. MoCA: 29.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The entorhinal cortex shows moderate atrophy (Z-score -1.55, 6.1th percentile), which is a key early marker for Alzheimer's pathology. However, hippocampal and other brain volumes are normal, and cognitive scores (MMSE, MoCA) are intact, suggesting no significant functional impairment.  \nDiagnosis: **MCI** (due to structural changes without overt cognitive decline)  \nConfidence: **Medium** (atrophy in a critical region but no clinical symptoms yet)",
  "timestamp": "2025-07-26T14:01:41.808516"
}