{
  "ptid_time": "027_S_0408_2007-11-13",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0408/2007-11-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 82,047 mm³, 74.5% above the reference mean. With a Z-score of 2.16 (98.5th percentile), this represents significant enlargement; hippocampal volume measures 5,860 mm³, 15.9% below the reference mean. With a Z-score of -1.37 (8.5th percentile), this represents mild atrophy; whole brain volume measures 1,130,390 mm³, 9.8% above the reference mean. With a Z-score of 1.29 (90.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 1,894 mm³, 52.3% below the reference mean. With a Z-score of -3.42 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,184 mm³, 10.4% below the reference mean. With a Z-score of -0.90 (18.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,274 mm³, 4.5% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume . ",
  "text_data": "Age is 83.7 years. Gender is Male. Education: 20 years. MMSE: 26.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.16) and profound entorhinal cortex atrophy (Z-score -3.42), which are strong indicators of neurodegeneration. Mild hippocampal atrophy (Z-score -1.37) and normal volumes in fusiform gyrus and middle temporal gyrus suggest early-stage changes. The MMSE score of 26 is borderline, but structural changes point toward cognitive decline.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Clinical correlation needed due to borderline MMSE and absence of APOE4 risk allele, but structural changes strongly suggest MCI.)",
  "timestamp": "2025-07-26T03:37:24.615648"
}