{
  "ptid_time": "029_S_1215_2007-09-04",
  "img_path": "/data/qiuhui/data/adni/images/029_S_1215/2007-09-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 103,268 mm³, 168.1% above the reference mean. With a Z-score of 4.03 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,261 mm³, 3.9% below the reference mean. With a Z-score of -0.38 (35.0th percentile), this represents normal volume ; whole brain volume measures 1,107,750 mm³, 2.6% above the reference mean. With a Z-score of 0.34 (63.3th 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 19,411 mm³, 3.0% above the reference mean. With a Z-score of 0.26 (60.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,195 mm³, 14.7% below the reference mean. With a Z-score of -1.32 (9.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 79.0 years. Gender is Male. Education: 16 years. MMSE: 29.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (Z-score 4.03), which is strongly suggestive of significant brain atrophy, particularly in the context of normal aging or neurodegenerative disease. However, hippocampal and entorhinal cortex volumes are within normal limits, and the MMSE score of 29 is intact, making frank dementia unlikely. The mild atrophy in the middle temporal gyrus could indicate early neurodegeneration, but the absence of cognitive impairment suggests this may not yet be clinically significant.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given structural changes without clear cognitive deficits)  \n**Confidence:** **Medium** (due to conflicting imaging findings—severe ventricular enlargement but normal cognition and mostly preserved regional volumes)",
  "timestamp": "2025-07-26T04:22:29.559843"
}