{
  "ptid_time": "051_S_1131_2008-02-05",
  "img_path": "/data/qiuhui/data/adni/images/051_S_1131/2008-02-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 105,593 mm³, 124.6% above the reference mean. With a Z-score of 3.62 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,943 mm³, 14.0% above the reference mean. With a Z-score of 1.21 (88.7th percentile), this represents mild enlargement; whole brain volume measures 1,097,030 mm³, 6.6% above the reference mean. With a Z-score of 0.86 (80.6th percentile), this represents normal volume ; entorhinal cortex volume measures 4,092 mm³, 3.1% above the reference mean. With a Z-score of 0.20 (58.0th percentile), this represents normal volume ; fusiform gyrus volume measures 20,545 mm³, 13.7% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,185 mm³, 14.9% above the reference mean. With a Z-score of 1.34 (91.0th percentile), this represents mild enlargement. ",
  "text_data": "Age is 87.4 years. Gender is Male. Education: 7 years. MMSE: 30.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.62), which is strongly associated with neurodegeneration, but hippocampal and other temporal lobe volumes are normal or mildly enlarged, not atrophic. The MMSE score of 30 is intact, and there is no APOE4 risk allele. Given the absence of cognitive impairment and preserved cortical volumes, ventricular enlargement may reflect age-related changes rather than dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the discrepancy between ventricular enlargement and preserved cognitive/structural measures, suggesting possible non-pathological aging or another non-AD cause for ventriculomegaly)",
  "timestamp": "2025-07-26T07:34:28.558321"
}