{
  "ptid_time": "137_S_4482_2013-03-15",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4482/2013-03-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,554 mm³, 37.5% below the reference mean. With a Z-score of -0.86 (19.6th percentile), this represents normal volume ; hippocampal volume measures 7,088 mm³, 0.4% below the reference mean. With a Z-score of -0.03 (48.6th percentile), this represents normal volume ; whole brain volume measures 926,564 mm³, 4.9% below the reference mean. With a Z-score of -0.62 (26.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,713 mm³, 26.1% below the reference mean. With a Z-score of -1.60 (5.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,465 mm³, 3.2% below the reference mean. With a Z-score of -0.29 (38.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,584 mm³, 3.1% below the reference mean. With a Z-score of -0.27 (39.5th percentile), this represents normal volume . ",
  "text_data": "Age is 78.2 years. Gender is Female. Education: 16 years. MMSE: 28.0. MoCA: 29.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.60, 5.4th percentile), which is a key early marker of Alzheimer's pathology. However, hippocampal and whole brain volumes are within normal ranges, and cognitive scores (MMSE 28, MoCA 29) are intact. No APOE4 risk alleles are present.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to isolated entorhinal atrophy but preserved cognition).  \n**Confidence:** **Medium** (atrophy in a critical region suggests early neurodegeneration, but cognitive performance is still normal).",
  "timestamp": "2025-07-26T16:33:20.879399"
}