{
  "ptid_time": "031_S_1066_2008-06-05",
  "img_path": "/data/qiuhui/data/adni/images/031_S_1066/2008-06-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,554 mm³, 2.5% below the reference mean. With a Z-score of -0.06 (47.6th percentile), this represents normal volume ; hippocampal volume measures 4,845 mm³, 35.9% below the reference mean. With a Z-score of -3.50 (0.0th percentile), this represents profound atrophy; whole brain volume measures 909,398 mm³, 15.7% below the reference mean. With a Z-score of -2.04 (2.0th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,873 mm³, 29.9% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,518 mm³, 22.9% below the reference mean. With a Z-score of -1.95 (2.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 14,557 mm³, 31.8% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 73.9 years. Gender is Male. Education: 13 years. MMSE: 30.0. Laboratory findings: Albumin: 4.90 (significant elevated); Creatine Kinase: 455.00 (profound elevated). APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.50) and significant atrophy in the entorhinal cortex, whole brain, and middle temporal gyrus, which are hallmark features of Alzheimer's disease. Despite a normal MMSE score (30/30), the structural changes and APOE4 homozygosity strongly suggest underlying neurodegeneration.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Note: The MMSE score may not yet reflect functional decline, but the severe atrophy and APOE4 status indicate advanced pathology.)*",
  "timestamp": "2025-07-26T04:39:51.065775"
}