{
  "ptid_time": "027_S_0118_2006-08-16",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0118/2006-08-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,213 mm³, 18.7% below the reference mean. With a Z-score of -0.54 (29.3th percentile), this represents normal volume ; hippocampal volume measures 5,365 mm³, 23.0% below the reference mean. With a Z-score of -1.99 (2.3th percentile), this represents moderate atrophy; whole brain volume measures 941,244 mm³, 8.5% below the reference mean. With a Z-score of -1.12 (13.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,685 mm³, 32.4% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,028 mm³, 11.3% below the reference mean. With a Z-score of -0.98 (16.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,958 mm³, 11.0% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume . ",
  "text_data": "Age is 80.9 years. Gender is Male. Education: 20 years. MMSE: 29.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex (both below the 3rd percentile), which are key regions affected in Alzheimer's disease, despite normal cognitive performance (MMSE 29). The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes despite intact cognition).  \n**Confidence:** **Medium** (high atrophy in AD-related regions but normal MMSE complicates the picture).  \n\n*Note: Follow-up cognitive testing (e.g., episodic memory tasks) and biomarker analysis (CSF Aβ/tau or PET) would strengthen confidence.*",
  "timestamp": "2025-07-26T03:28:33.697462"
}