{
  "ptid_time": "082_S_0469_2006-06-06",
  "img_path": "/data/qiuhui/data/adni/images/082_S_0469/2006-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 65,117 mm³, 132.0% above the reference mean. With a Z-score of 3.02 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 4,961 mm³, 30.3% below the reference mean. With a Z-score of -2.78 (0.3th percentile), this represents significant atrophy; whole brain volume measures 790,659 mm³, 18.9% below the reference mean. With a Z-score of -2.38 (0.9th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,658 mm³, 27.6% below the reference mean. With a Z-score of -1.70 (4.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,260 mm³, 16.2% below the reference mean. With a Z-score of -1.47 (7.0th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,645 mm³, 18.4% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 78.4 years. Gender is Female. Education: 18 years. MMSE: 27.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound ventricular enlargement and significant atrophy in the hippocampus, whole brain, and other key regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus), which are strongly associated with Alzheimer's pathology. Despite a relatively preserved MMSE score (27/30), the degree of structural brain changes suggests neurodegeneration beyond normal aging.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given atrophy pattern, though APOE4-negative status slightly reduces certainty).  \n\n**Confidence:** **Medium** (High confidence in neurodegeneration, but MCI diagnosis is provisional due to the discrepancy between imaging severity and preserved MMSE).  \n\n*Note: Follow-up cognitive testing (e.g., neuropsychological battery) and CSF/blood biomarkers (e.g., p-tau181, Aβ42/40) would strengthen diagnostic certainty.*",
  "timestamp": "2025-07-26T09:57:47.337056"
}