{
  "ptid_time": "007_S_4488_2013-02-14",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4488/2013-02-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,958 mm³, 40.4% below the reference mean. With a Z-score of -0.97 (16.7th percentile), this represents normal volume ; hippocampal volume measures 9,059 mm³, 19.8% above the reference mean. With a Z-score of 1.94 (97.4th percentile), this represents moderate enlargement; whole brain volume measures 1,187,910 mm³, 10.1% above the reference mean. With a Z-score of 1.30 (90.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 5,102 mm³, 24.4% above the reference mean. With a Z-score of 1.66 (95.1th percentile), this represents moderate enlargement; fusiform gyrus volume measures 20,059 mm³, 6.5% above the reference mean. With a Z-score of 0.55 (70.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,656 mm³, 7.9% below the reference mean. With a Z-score of -0.71 (23.9th percentile), this represents normal volume . ",
  "text_data": "Age is 73.6 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 11.0. Laboratory findings: Basophils: 1.50 (significant elevated); Creatinine (Rate Blanked): 1.50 (significant elevated); Serum Uric Acid: 9.00 (significant elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows no significant atrophy in key regions typically affected in Alzheimer's (e.g., hippocampus is enlarged, not reduced). The MMSE is normal (29/30), but the MoCA (23/30) suggests mild cognitive impairment. The absence of APOE4 reduces genetic risk.  \n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (MoCA indicates possible impairment, but structural imaging does not strongly support neurodegeneration)",
  "timestamp": "2025-07-25T22:01:50.747668"
}