{
  "ptid_time": "051_S_1131_2007-01-18",
  "img_path": "/data/qiuhui/data/adni/images/051_S_1131/2007-01-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 98,046 mm³, 108.5% above the reference mean. With a Z-score of 3.15 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 7,920 mm³, 13.7% above the reference mean. With a Z-score of 1.18 (88.1th percentile), this represents mild enlargement; whole brain volume measures 1,134,740 mm³, 10.3% above the reference mean. With a Z-score of 1.34 (91.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,855 mm³, 2.9% below the reference mean. With a Z-score of -0.19 (42.5th percentile), this represents normal volume ; fusiform gyrus volume measures 20,447 mm³, 13.2% above the reference mean. With a Z-score of 1.14 (87.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,517 mm³, 16.6% above the reference mean. With a Z-score of 1.49 (93.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 86.4 years. Gender is Male. Education: 7 years. MMSE: 25.0. Logical Memory: 1.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (Z-score 3.15), which is strongly associated with neurodegeneration, but hippocampal and whole brain volumes are mildly enlarged rather than atrophied. The MMSE score of 25 is borderline but not definitively impaired. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Ventricular enlargement suggests neurodegeneration, but preserved hippocampal volume and borderline MMSE make dementia less likely.)",
  "timestamp": "2025-07-26T07:33:56.792135"
}