{
  "ptid_time": "100_S_1286_2009-08-31",
  "img_path": "/data/qiuhui/data/adni/images/100_S_1286/2009-08-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,418 mm³, 83.2% above the reference mean. With a Z-score of 1.90 (97.2th percentile), this represents moderate enlargement; hippocampal volume measures 8,411 mm³, 18.2% above the reference mean. With a Z-score of 1.67 (95.3th percentile), this represents moderate enlargement; whole brain volume measures 1,084,470 mm³, 11.3% above the reference mean. With a Z-score of 1.42 (92.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,575 mm³, 24.6% above the reference mean. With a Z-score of 1.51 (93.4th percentile), this represents moderate enlargement; fusiform gyrus volume measures 15,181 mm³, 10.8% below the reference mean. With a Z-score of -0.98 (16.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,183 mm³, 15.7% above the reference mean. With a Z-score of 1.36 (91.4th percentile), this represents mild enlargement. ",
  "text_data": "Age is 78.5 years. Gender is Female. Education: 19 years. MMSE: 30.0. Logical Memory: 22.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mixed findings, with several regions (ventricles, hippocampus, whole brain, entorhinal cortex, middle temporal gyrus) showing enlargement above the reference mean, while the fusiform gyrus is slightly below. The MMSE score of 30 is normal, and the absence of APOE4 reduces genetic risk. Enlargement in some regions could suggest compensatory mechanisms or early neurodegenerative changes, but no clear atrophy is present.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mixed volumetric findings despite normal cognition)",
  "timestamp": "2025-07-26T11:23:26.427269"
}