{
  "ptid_time": "941_S_1202_2008-02-28",
  "img_path": "/data/qiuhui/data/adni/images/941_S_1202/2008-02-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,534 mm³, 44.2% above the reference mean. With a Z-score of 1.06 (85.5th percentile), this represents mild enlargement; hippocampal volume measures 6,275 mm³, 17.0% below the reference mean. With a Z-score of -1.66 (4.9th percentile), this represents moderate atrophy; whole brain volume measures 1,016,540 mm³, 5.8% below the reference mean. With a Z-score of -0.76 (22.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,206 mm³, 46.2% below the reference mean. With a Z-score of -3.13 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 19,162 mm³, 1.7% above the reference mean. With a Z-score of 0.15 (55.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,587 mm³, 3.5% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume . ",
  "text_data": "Age is 78.5 years. Gender is Male. Education: 18 years. MMSE: 30.0. Logical Memory: 10.0. Laboratory findings: MCH: 34.00 (significant elevated); MCHC: 36.00 (significant elevated); Total Bilirubin: 0.80 (significant elevated); Total Protein: 6.10 (significant reduced); Creatine Kinase: 218.00 (significant elevated); LDH: 268.00 (profound elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus (Z-score -1.66, 4.9th percentile) and profound atrophy in the entorhinal cortex (Z-score -3.13, 0.1st percentile), both key regions affected in Alzheimer’s disease. However, cognitive performance (MMSE 30/30) is intact, and whole-brain volume is within normal limits, suggesting no functional impairment yet.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to hippocampal and entorhinal atrophy).  \n\n**Confidence:** **Medium** (structural changes are concerning, but the lack of cognitive symptoms prevents a dementia diagnosis; APOE4-negative status and preserved MMSE suggest slower progression).  \n\n*Note: Close clinical monitoring is recommended due to high-risk neuroanatomical findings.*",
  "timestamp": "2025-07-26T17:29:13.490964"
}