{
  "ptid_time": "022_S_4291_2012-08-08",
  "img_path": "/data/qiuhui/data/adni/images/022_S_4291/2012-08-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 64,123 mm³, 128.5% above the reference mean. With a Z-score of 2.94 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 6,454 mm³, 9.3% below the reference mean. With a Z-score of -0.85 (19.7th percentile), this represents normal volume ; whole brain volume measures 906,334 mm³, 7.0% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,917 mm³, 6.6% above the reference mean. With a Z-score of 0.41 (65.8th percentile), this represents normal volume ; fusiform gyrus volume measures 16,808 mm³, 1.2% below the reference mean. With a Z-score of -0.11 (45.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,681 mm³, 7.8% below the reference mean. With a Z-score of -0.67 (25.0th percentile), this represents normal volume . ",
  "text_data": "Age is 76.0 years. Gender is Female. Education: 20 years. MMSE: 29.0. MoCA: 30.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.94), which is often associated with neurodegeneration, but hippocampal and whole brain volumes are within normal ranges. Cognitive scores (MMSE 29, MoCA 30) are unimpaired, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Ventricular enlargement raises suspicion, but normal cognition and other brain volumes suggest no current impairment.)",
  "timestamp": "2025-07-26T02:19:15.547952"
}