{
  "ptid_time": "067_S_4212_2012-09-19",
  "img_path": "/data/qiuhui/data/adni/images/067_S_4212/2012-09-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 62,210 mm³, 107.2% above the reference mean. With a Z-score of 2.55 (99.5th percentile), this represents significant enlargement; hippocampal volume measures 8,296 mm³, 3.4% above the reference mean. With a Z-score of 0.33 (63.1th percentile), this represents normal volume ; whole brain volume measures 1,252,090 mm³, 10.4% above the reference mean. With a Z-score of 1.47 (92.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,330 mm³, 21.9% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 24,059 mm³, 20.8% above the reference mean. With a Z-score of 1.73 (95.8th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 27,305 mm³, 21.8% above the reference mean. With a Z-score of 1.80 (96.4th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 65.7 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.55) and moderate entorhinal cortex atrophy (Z-score -1.51), both of which are associated with neurodegeneration. However, hippocampal volume is normal, and cognitive scores (MMSE 30, MoCA 26) are within normal limits, suggesting no significant functional impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are concerning, but cognitive performance remains intact, making early MCI more likely than dementia. Lack of APOE4 reduces but does not eliminate Alzheimer’s risk.)  \n\n*Note: Follow-up clinical correlation (e.g., neuropsychological testing, CSF biomarkers, or amyloid PET) would strengthen confidence.*",
  "timestamp": "2025-07-26T08:38:19.368481"
}