{
  "ptid_time": "141_S_0982_2008-05-14",
  "img_path": "/data/qiuhui/data/adni/images/141_S_0982/2008-05-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,686 mm³, 34.4% above the reference mean. With a Z-score of 0.93 (82.4th percentile), this represents normal volume ; hippocampal volume measures 5,751 mm³, 11.5% below the reference mean. With a Z-score of -0.92 (17.9th percentile), this represents normal volume ; whole brain volume measures 1,021,320 mm³, 10.0% above the reference mean. With a Z-score of 1.20 (88.6th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,908 mm³, 16.0% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; fusiform gyrus volume measures 15,496 mm³, 3.8% below the reference mean. With a Z-score of -0.29 (38.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,340 mm³, 3.8% below the reference mean. With a Z-score of -0.34 (36.7th percentile), this represents normal volume . ",
  "text_data": "Age is 81.7 years. Gender is Female. Education: 16 years. MMSE: 22.0. Laboratory findings: Thyroid Stim. Hormone: 3.87 (significant elevated); Creatine Kinase: 360.00 (profound elevated); Urea Nitrogen: 29.00 (significant elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume is slightly reduced (11.5% below mean, Z-score -0.92), and the entorhinal cortex is moderately reduced (16.0% below mean, Z-score -0.86), which may suggest early neurodegeneration. However, other brain volumes are within normal ranges or even enlarged (whole brain volume). The MMSE score of 22 indicates mild cognitive impairment, but the absence of APOE4 reduces genetic risk for Alzheimer’s.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline hippocampal/entorhinal reductions and MMSE score, but lack of widespread atrophy or strong genetic risk)",
  "timestamp": "2025-07-26T16:52:28.640195"
}