{
  "ptid_time": "126_S_4514_2018-06-06",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4514/2018-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 65,760 mm³, 134.3% above the reference mean. With a Z-score of 3.08 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 7,863 mm³, 10.5% above the reference mean. With a Z-score of 0.97 (83.3th percentile), this represents normal volume ; whole brain volume measures 967,569 mm³, 0.7% below the reference mean. With a Z-score of -0.09 (46.4th percentile), this represents normal volume ; entorhinal cortex volume measures 4,177 mm³, 13.7% above the reference mean. With a Z-score of 0.84 (80.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,638 mm³, 2.2% below the reference mean. With a Z-score of -0.20 (42.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,485 mm³, 1.6% above the reference mean. With a Z-score of 0.14 (55.7th percentile), this represents normal volume . ",
  "text_data": "Age is 74.1 years. Gender is Female. Education: 14 years. MMSE: 29.0. MoCA: 24.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.08), which is strongly associated with neurodegeneration, but hippocampal and other regional volumes are within normal ranges. Cognitive scores (MMSE 29, MoCA 24) suggest mild cognitive impairment (MCI) rather than dementia, given the preserved MMSE but borderline MoCA. APOE4 positivity increases Alzheimer's risk.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting ventricular enlargement vs. normal regional volumes and borderline MoCA)",
  "timestamp": "2025-07-26T12:47:57.528372"
}