{
  "ptid_time": "073_S_4300_2012-10-17",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4300/2012-10-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 114,358 mm³, 209.4% above the reference mean. With a Z-score of 5.65 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,779 mm³, 11.0% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; whole brain volume measures 885,737 mm³, 4.6% below the reference mean. With a Z-score of -0.55 (29.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,408 mm³, 1.6% below the reference mean. With a Z-score of -0.09 (46.6th percentile), this represents normal volume ; fusiform gyrus volume measures 16,174 mm³, 0.4% above the reference mean. With a Z-score of 0.03 (51.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,593 mm³, 14.2% above the reference mean. With a Z-score of 1.27 (89.7th percentile), this represents mild enlargement. ",
  "text_data": "Age is 81.6 years. Gender is Female. Education: 16 years. MMSE: 24.0. MoCA: 22.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 5.65), which is strongly suggestive of significant brain atrophy, particularly in the context of an 81-year-old patient. However, hippocampal and other regional volumes (entorhinal cortex, fusiform gyrus) are within normal limits, and cognitive scores (MMSE 24, MoCA 22) are borderline but not severely impaired. The absence of APOE4 reduces genetic risk but does not rule out neurodegenerative disease.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting findings—severe ventricular enlargement suggests neurodegeneration, but preserved hippocampal volume and only mild cognitive decline suggest MCI rather than full dementia).",
  "timestamp": "2025-07-26T09:42:20.034566"
}