{
  "ptid_time": "003_S_6258_2019-05-02",
  "img_path": "/data/qiuhui/data/adni/images/003_S_6258/2019-05-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 76,696 mm³, 63.1% above the reference mean. With a Z-score of 1.83 (96.7th percentile), this represents moderate enlargement; hippocampal volume measures 6,496 mm³, 6.8% below the reference mean. With a Z-score of -0.59 (27.9th percentile), this represents normal volume ; whole brain volume measures 1,122,600 mm³, 9.1% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,882 mm³, 2.2% below the reference mean. With a Z-score of -0.14 (44.3th percentile), this represents normal volume ; fusiform gyrus volume measures 19,508 mm³, 8.0% above the reference mean. With a Z-score of 0.69 (75.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,771 mm³, 7.9% above the reference mean. With a Z-score of 0.71 (76.1th percentile), this represents normal volume . ",
  "text_data": "Age is 80.8 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 24.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is moderately enlarged (Z-score 1.83), which can indicate atrophy, but hippocampal volume is normal (Z-score -0.59), and other regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. The MMSE is intact (30/30), but the MoCA (24/30) suggests mild cognitive impairment, possibly due to non-memory domains (e.g., executive function, attention). APOE4 carrier status increases Alzheimer’s risk, but structural findings do not strongly support neurodegeneration.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (MoCA suggests impairment, but structural changes are not severe enough for dementia; clinical correlation needed).",
  "timestamp": "2025-07-25T21:00:17.887101"
}