{
  "ptid_time": "029_S_0878_2008-04-23",
  "img_path": "/data/qiuhui/data/adni/images/029_S_0878/2008-04-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,735 mm³, 25.4% below the reference mean. With a Z-score of -0.61 (27.1th percentile), this represents normal volume ; hippocampal volume measures 6,137 mm³, 18.8% below the reference mean. With a Z-score of -1.84 (3.3th percentile), this represents moderate atrophy; whole brain volume measures 991,813 mm³, 8.1% below the reference mean. With a Z-score of -1.05 (14.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,912 mm³, 29.0% below the reference mean. With a Z-score of -1.97 (2.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,956 mm³, 25.9% below the reference mean. With a Z-score of -2.21 (1.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,954 mm³, 29.9% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy. ",
  "text_data": "Age is 73.8 years. Gender is Male. Education: 14 years. MMSE: 26.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus), while ventricular volume is normal. The MMSE score of 26 is borderline, and the presence of one APOE4 allele increases Alzheimer's risk. The pattern of atrophy is consistent with early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's disease)  \n\n**Confidence:** **Medium** (clinical correlation with cognitive testing and longitudinal follow-up would strengthen certainty).",
  "timestamp": "2025-07-26T04:19:33.455062"
}