{
  "ptid_time": "051_S_4929_2013-05-28",
  "img_path": "/data/qiuhui/data/adni/images/051_S_4929/2013-05-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,433 mm³, 90.4% above the reference mean. With a Z-score of 2.07 (98.1th percentile), this represents significant enlargement; hippocampal volume measures 4,746 mm³, 33.3% below the reference mean. With a Z-score of -3.05 (0.1th percentile), this represents profound atrophy; whole brain volume measures 848,030 mm³, 13.0% below the reference mean. With a Z-score of -1.64 (5.1th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,771 mm³, 24.6% below the reference mean. With a Z-score of -1.51 (6.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 10,253 mm³, 39.7% below the reference mean. With a Z-score of -3.62 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 14,356 mm³, 25.1% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy. ",
  "text_data": "Age is 76.2 years. Gender is Female. Education: 15 years. MMSE: 25.0. MoCA: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus and fusiform gyrus, significant ventricular enlargement, and moderate-to-severe atrophy in other key regions (entorhinal cortex, middle temporal gyrus, whole brain). These findings, combined with cognitive scores (MMSE 25, MoCA 20) below typical thresholds for normal aging, strongly suggest neurodegenerative pathology. The presence of one APOE4 allele further supports Alzheimer's-like changes.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease subtype)  \n**Confidence:** **High** (structural atrophy patterns and cognitive deficits align clearly with dementia; APOE4 adds supporting evidence).",
  "timestamp": "2025-07-26T07:37:26.244925"
}