{
  "ptid_time": "018_S_0425_2006-06-19",
  "img_path": "/data/qiuhui/data/adni/images/018_S_0425/2006-06-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,014 mm³, 25.5% above the reference mean. With a Z-score of 0.74 (77.1th percentile), this represents normal volume ; hippocampal volume measures 6,545 mm³, 6.1% below the reference mean. With a Z-score of -0.52 (30.0th percentile), this represents normal volume ; whole brain volume measures 963,450 mm³, 6.4% below the reference mean. With a Z-score of -0.84 (20.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,195 mm³, 19.5% below the reference mean. With a Z-score of -1.28 (10.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 13,997 mm³, 22.5% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,975 mm³, 20.8% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 85.8 years. Gender is Male. Education: 20 years. MMSE: 29.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild to moderate atrophy in key regions associated with Alzheimer's disease (entorhinal cortex, fusiform gyrus, middle temporal gyrus), but hippocampal and whole-brain volumes are within normal limits. Despite these structural changes, the MMSE score of 29 is intact, and there is no APOE4 genetic risk factor.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural atrophy suggests early neurodegeneration, but cognitive performance remains normal, making progression to dementia uncertain at this stage.)",
  "timestamp": "2025-07-26T00:49:47.615178"
}