{
  "ptid_time": "016_S_0359_2007-07-09",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0359/2007-07-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,580 mm³, 14.6% below the reference mean. With a Z-score of -0.39 (34.7th percentile), this represents normal volume ; hippocampal volume measures 6,350 mm³, 2.2% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; whole brain volume measures 771,758 mm³, 16.9% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,350 mm³, 3.3% below the reference mean. With a Z-score of -0.18 (43.0th percentile), this represents normal volume ; fusiform gyrus volume measures 15,535 mm³, 3.6% below the reference mean. With a Z-score of -0.27 (39.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,012 mm³, 16.7% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy. ",
  "text_data": "Age is 82.3 years. Gender is Female. Education: 14 years. MMSE: 29.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The whole brain volume shows significant atrophy (Z-score -2.02, 2.2nd percentile), and the middle temporal gyrus exhibits mild atrophy (Z-score -1.49, 6.8th percentile). However, hippocampal and other regional volumes are within normal limits, and the MMSE score of 29 is intact. Given the absence of cognitive impairment and APOE4 negativity, the atrophy may reflect age-related changes rather than neurodegenerative disease.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to significant whole-brain atrophy but preserved cognition and normal hippocampal volume)",
  "timestamp": "2025-07-26T00:01:23.003423"
}