{
  "ptid_time": "002_S_4229_2019-11-13",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4229/2019-11-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 88,464 mm³, 129.7% above the reference mean. With a Z-score of 3.11 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 6,645 mm³, 12.1% below the reference mean. With a Z-score of -1.18 (11.9th percentile), this represents mild atrophy; whole brain volume measures 1,034,420 mm³, 4.2% below the reference mean. With a Z-score of -0.54 (29.4th percentile), this represents normal volume ; entorhinal cortex volume measures 3,945 mm³, 3.8% below the reference mean. With a Z-score of -0.26 (39.8th percentile), this represents normal volume ; fusiform gyrus volume measures 17,761 mm³, 5.7% below the reference mean. With a Z-score of -0.49 (31.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,725 mm³, 1.8% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume . ",
  "text_data": "Age is 74.4 years. Gender is Male. Education: 15 years. MMSE: 28.0. MoCA: 21.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.11) and mild hippocampal atrophy (Z-score -1.18), which are concerning for neurodegenerative changes. However, cognitive scores are mixed (MMSE 28 is normal, MoCA 21 suggests mild impairment), and other brain regions are largely within normal limits. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting cognitive scores and lack of widespread atrophy, but ventricular enlargement and hippocampal atrophy suggest early pathology)",
  "timestamp": "2025-07-25T20:24:19.655248"
}