{
  "ptid_time": "141_S_0915_2008-05-13",
  "img_path": "/data/qiuhui/data/adni/images/141_S_0915/2008-05-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,213 mm³, 39.9% below the reference mean. With a Z-score of -1.08 (14.1th percentile), this represents mild atrophy; hippocampal volume measures 4,341 mm³, 33.2% below the reference mean. With a Z-score of -2.66 (0.4th percentile), this represents significant atrophy; whole brain volume measures 775,109 mm³, 16.5% below the reference mean. With a Z-score of -1.98 (2.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,813 mm³, 47.6% below the reference mean. With a Z-score of -2.57 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,130 mm³, 24.7% below the reference mean. With a Z-score of -1.86 (3.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 10,922 mm³, 39.4% below the reference mean. With a Z-score of -3.51 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 82.1 years. Gender is Female. Education: 14 years. MMSE: 28.0. Laboratory findings: Serum Glucose: 153.00 (profound elevated); Triglycerides (GPO): 380.00 (profound elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, middle temporal gyrus) with Z-scores well below -2.0, indicating severe neurodegeneration. However, the MMSE score of 28 is within the normal range (≥26), suggesting preserved cognitive function despite structural changes. This discrepancy between imaging and clinical presentation is unusual for typical Alzheimer’s progression.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (High confidence in structural atrophy, but low confidence in clinical correlation due to normal MMSE; possible preclinical or resilient phenotype).  \n\n*Note: Further clinical evaluation (e.g., neuropsychological testing, CSF biomarkers, or FDG-PET) would strengthen diagnostic certainty.*",
  "timestamp": "2025-07-26T16:51:47.808136"
}