{
  "ptid_time": "024_S_1393_2008-04-07",
  "img_path": "/data/qiuhui/data/adni/images/024_S_1393/2008-04-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 84,596 mm³, 79.9% above the reference mean. With a Z-score of 2.32 (99.0th percentile), this represents significant enlargement; hippocampal volume measures 4,152 mm³, 40.4% below the reference mean. With a Z-score of -3.49 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,058,630 mm³, 2.9% above the reference mean. With a Z-score of 0.38 (64.6th percentile), this represents normal volume ; entorhinal cortex volume measures 1,876 mm³, 52.7% below the reference mean. With a Z-score of -3.45 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 15,454 mm³, 14.5% below the reference mean. With a Z-score of -1.25 (10.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 13,959 mm³, 30.8% below the reference mean. With a Z-score of -2.76 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 83.5 years. Gender is Male. Education: 18 years. MMSE: 26.0. Logical Memory: 0.0. Laboratory findings: Monocytes: 0.68 (significant elevated); Creatine Kinase: 319.00 (profound elevated); LDH: 285.00 (profound elevated); ALT (SGPT): 34.00 (significant elevated); AST (SGOT): 41.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Pittsburgh compound B: 2.25 SUVR (moderate elevated); Amyloid beta: 722.10 pg/mL (normal ); Total tau: 269.70 pg/mL (normal ); Phosphorylated tau: 23.46 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal and entorhinal cortex atrophy, along with ventricular enlargement—hallmarks of neurodegeneration. However, the MMSE score of 26 is borderline normal, and CSF biomarkers (Aβ, T-tau, P-tau) are normal, suggesting no active amyloid or tau pathology typical of Alzheimer’s.  \n\n**Diagnosis:** **MCI** (likely non-amyloid/non-AD etiology, such as hippocampal sclerosis or age-related tauopathy)  \n**Confidence:** **Medium** (structural atrophy is severe, but biomarker profile and MMSE complicate a dementia diagnosis).",
  "timestamp": "2025-07-26T03:15:09.347840"
}