{
  "ptid_time": "082_S_0928_2008-06-05",
  "img_path": "/data/qiuhui/data/adni/images/082_S_0928/2008-06-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,356 mm³, 14.6% above the reference mean. With a Z-score of 0.39 (65.3th percentile), this represents normal volume ; hippocampal volume measures 4,849 mm³, 25.3% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy; whole brain volume measures 781,515 mm³, 15.8% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,946 mm³, 14.9% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; fusiform gyrus volume measures 11,671 mm³, 27.6% below the reference mean. With a Z-score of -2.07 (1.9th percentile), this represents significant atrophy; middle temporal gyrus volume measures 17,109 mm³, 5.1% below the reference mean. With a Z-score of -0.45 (32.5th percentile), this represents normal volume . ",
  "text_data": "Age is 84.3 years. Gender is Female. Education: 20 years. MMSE: 27.0. Laboratory findings: MCH: 24.00 (profound reduced); Hematocrit: 33.00 (significant reduced); Hemoglobin: 10.60 (significant reduced). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and fusiform gyrus volumes show significant atrophy (Z-scores ≤ -2.0), while whole brain volume shows moderate atrophy (Z-score -1.90). The MMSE score of 27 is within the normal range, but given the structural atrophy, particularly in memory-related regions, this suggests possible early neurodegeneration. The absence of APOE4 reduces genetic risk but does not rule out Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to normal MMSE but significant structural atrophy in key regions)",
  "timestamp": "2025-07-26T10:00:00.528947"
}