{
  "ptid_time": "072_S_4871_2013-08-28",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4871/2013-08-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,344 mm³, 71.7% above the reference mean. With a Z-score of 1.79 (96.4th percentile), this represents moderate enlargement; hippocampal volume measures 7,230 mm³, 5.9% below the reference mean. With a Z-score of -0.66 (25.3th percentile), this represents normal volume ; whole brain volume measures 983,317 mm³, 4.5% below the reference mean. With a Z-score of -0.55 (29.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,965 mm³, 1.9% above the reference mean. With a Z-score of 0.14 (55.7th percentile), this represents normal volume ; fusiform gyrus volume measures 19,607 mm³, 7.7% above the reference mean. With a Z-score of 0.86 (80.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,282 mm³, 1.2% below the reference mean. With a Z-score of -0.10 (45.9th percentile), this represents normal volume . ",
  "text_data": "Age is 67.4 years. Gender is Female. Education: 14 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is moderately enlarged (71.7% above mean, Z-score 1.79), which can indicate atrophy, but hippocampal and whole brain volumes are within normal limits. Cognitive scores (MMSE 28, MoCA 24) suggest mild cognitive impairment (MCI), particularly given the MoCA score below the typical cutoff of 26. No APOE4 allele reduces Alzheimer's genetic risk.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting ventricular enlargement vs. normal hippocampal volume and borderline MoCA score)",
  "timestamp": "2025-07-26T09:26:53.028579"
}