{
  "ptid_time": "114_S_5234_2019-02-06",
  "img_path": "/data/qiuhui/data/adni/images/114_S_5234/2019-02-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 129,409 mm³, 250.1% above the reference mean. With a Z-score of 6.75 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,446 mm³, 14.6% above the reference mean. With a Z-score of 1.17 (88.0th percentile), this represents mild enlargement; whole brain volume measures 1,077,250 mm³, 16.1% above the reference mean. With a Z-score of 1.93 (97.3th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,184 mm³, 20.8% above the reference mean. With a Z-score of 1.12 (87.0th percentile), this represents mild enlargement; fusiform gyrus volume measures 18,956 mm³, 17.7% above the reference mean. With a Z-score of 1.33 (90.8th percentile), this represents mild enlargement; middle temporal gyrus volume measures 18,296 mm³, 1.5% above the reference mean. With a Z-score of 0.13 (55.2th percentile), this represents normal volume . ",
  "text_data": "Age is 84.1 years. Gender is Female. Education: 15 years. MMSE: 28.0. MoCA: 18.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 6.75), which is strongly suggestive of significant brain atrophy, particularly in the context of an otherwise enlarged whole brain and regional volumes. The MMSE score of 28 is within the normal range, but the MoCA score of 18 indicates significant cognitive impairment, particularly in executive function, attention, and memory domains. The discrepancy between MMSE and MoCA, along with the structural changes, suggests cognitive decline despite preserved global cognition on MMSE.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given MoCA performance and hippocampal/entorhinal involvement).  \n\n**Confidence:** **Medium** (while structural changes and MoCA strongly suggest MCI, the normal MMSE and lack of APOE4 status introduce some uncertainty; clinical correlation with detailed neuropsychological testing would strengthen confidence).",
  "timestamp": "2025-07-26T11:48:26.554306"
}