{
  "ptid_time": "051_S_1131_2010-03-03",
  "img_path": "/data/qiuhui/data/adni/images/051_S_1131/2010-03-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 112,795 mm³, 139.9% above the reference mean. With a Z-score of 4.06 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,424 mm³, 6.5% above the reference mean. With a Z-score of 0.57 (71.4th percentile), this represents normal volume ; whole brain volume measures 1,065,690 mm³, 3.5% above the reference mean. With a Z-score of 0.47 (67.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,855 mm³, 2.9% below the reference mean. With a Z-score of -0.19 (42.5th percentile), this represents normal volume ; fusiform gyrus volume measures 20,751 mm³, 14.9% above the reference mean. With a Z-score of 1.29 (90.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,706 mm³, 17.5% above the reference mean. With a Z-score of 1.57 (94.2th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 89.4 years. Gender is Male. Education: 7 years. MMSE: 25.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 4.06), which is strongly associated with neurodegeneration, while hippocampal and whole brain volumes are within normal ranges. The MMSE score of 25 is borderline but not definitively impaired, and the absence of APOE4 reduces genetic risk. However, ventricular enlargement at this level is highly suggestive of underlying pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting markers—ventricular enlargement is severe, but cognitive testing is only mildly suggestive, and other structures are preserved)",
  "timestamp": "2025-07-26T07:34:57.036512"
}