{
  "ptid_time": "068_S_4332_2019-09-23",
  "img_path": "/data/qiuhui/data/adni/images/068_S_4332/2019-09-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 95,478 mm³, 147.9% above the reference mean. With a Z-score of 3.54 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,445 mm³, 1.5% below the reference mean. With a Z-score of -0.15 (44.1th percentile), this represents normal volume ; whole brain volume measures 1,269,520 mm³, 17.6% above the reference mean. With a Z-score of 2.29 (98.9th percentile), this represents significant enlargement; entorhinal cortex volume measures 4,829 mm³, 17.8% above the reference mean. With a Z-score of 1.20 (88.6th percentile), this represents mild enlargement; fusiform gyrus volume measures 27,240 mm³, 44.6% above the reference mean. With a Z-score of 3.80 (100.0th percentile), this represents profound enlargement; middle temporal gyrus volume measures 28,133 mm³, 31.8% above the reference mean. With a Z-score of 2.86 (99.8th percentile), this represents significant enlargement. ",
  "text_data": "Age is 77.0 years. Gender is Male. Education: 14 years. MMSE: 30.0. MoCA: 24.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.30 SUVR (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (consistent with atrophy) and significant enlargement in several brain regions, which may suggest compensatory mechanisms or atypical neurodegeneration. However, hippocampal volume is normal, and cognitive scores (MMSE 30, MoCA 24) are borderline for MCI but not dementia. The absence of APOE4 and moderate amyloid burden (AV45) complicates the picture.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—severe atrophy in some regions but preserved hippocampus—and borderline cognitive scores).",
  "timestamp": "2025-07-26T09:01:36.418825"
}