{
  "ptid_time": "018_S_4889_2013-02-28",
  "img_path": "/data/qiuhui/data/adni/images/018_S_4889/2013-02-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 61,281 mm³, 59.1% above the reference mean. With a Z-score of 1.42 (92.2th percentile), this represents mild enlargement; hippocampal volume measures 7,622 mm³, 0.8% above the reference mean. With a Z-score of 0.08 (53.2th percentile), this represents normal volume ; whole brain volume measures 1,203,210 mm³, 11.5% above the reference mean. With a Z-score of 1.49 (93.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,302 mm³, 4.9% above the reference mean. With a Z-score of 0.33 (63.0th percentile), this represents normal volume ; fusiform gyrus volume measures 17,789 mm³, 5.6% below the reference mean. With a Z-score of -0.47 (31.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,338 mm³, 0.0% below the reference mean. With a Z-score of -0.00 (50.0th percentile), this represents normal volume . ",
  "text_data": "Age is 76.1 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 27.0. Laboratory findings: MCH: 35.00 (significant elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is mildly enlarged (59.1% above reference mean, Z-score 1.42), which can be associated with aging or early neurodegenerative changes. However, hippocampal, entorhinal cortex, fusiform gyrus, and middle temporal gyrus volumes are all within normal ranges (Z-scores close to 0). Cognitive scores (MMSE 29, MoCA 27) are intact, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **High** (No significant atrophy in key AD-related regions, normal cognitive scores, and no genetic risk factors strongly suggest no cognitive impairment.)",
  "timestamp": "2025-07-26T01:01:35.527048"
}