{
  "ptid_time": "036_S_4894_2013-08-26",
  "img_path": "/data/qiuhui/data/adni/images/036_S_4894/2013-08-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,977 mm³, 65.5% above the reference mean. With a Z-score of 1.64 (95.0th percentile), this represents moderate enlargement; hippocampal volume measures 4,972 mm³, 35.3% below the reference mean. With a Z-score of -3.96 (0.0th percentile), this represents profound atrophy; whole brain volume measures 940,300 mm³, 8.6% below the reference mean. With a Z-score of -1.07 (14.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,787 mm³, 28.4% below the reference mean. With a Z-score of -2.20 (1.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,174 mm³, 5.7% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,256 mm³, 25.7% below the reference mean. With a Z-score of -2.28 (1.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 61.7 years. Gender is Female. Education: 14 years. MMSE: 18.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits profound hippocampal atrophy (Z-score -3.96), significant entorhinal cortex and middle temporal gyrus atrophy, and moderate ventricular enlargement—all hallmarks of Alzheimer's pathology. The MMSE score of 18 indicates severe cognitive impairment, consistent with dementia. The presence of one APOE4 allele further supports Alzheimer's risk.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T06:19:48.135704"
}