{
  "ptid_time": "135_S_4446_2013-01-22",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4446/2013-01-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,283 mm³, 22.6% below the reference mean. With a Z-score of -0.57 (28.6th percentile), this represents normal volume ; hippocampal volume measures 7,468 mm³, 2.8% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume ; whole brain volume measures 979,126 mm³, 4.9% below the reference mean. With a Z-score of -0.61 (27.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,225 mm³, 8.5% above the reference mean. With a Z-score of 0.66 (74.6th percentile), this represents normal volume ; fusiform gyrus volume measures 21,648 mm³, 18.9% above the reference mean. With a Z-score of 2.13 (98.3th percentile), this represents significant enlargement; middle temporal gyrus volume measures 18,949 mm³, 7.7% below the reference mean. With a Z-score of -0.68 (24.8th percentile), this represents normal volume . ",
  "text_data": "Age is 69.4 years. Gender is Female. Education: 15 years. MMSE: 29.0. MoCA: 27.0. Logical Memory: 11.0. Laboratory findings: Monocytes: 0.68 (significant elevated); Eosinophils: 0.35 (significant elevated); Monocytes: 10.30 (significant elevated); LDH: 247.00 (significant elevated); GGT: 56.00 (profound elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** All brain volumes (ventricular, hippocampal, whole brain, entorhinal cortex, middle temporal gyrus) are within normal ranges or slightly above/below the mean, with no significant atrophy. The fusiform gyrus shows enlargement, but this is not typically associated with Alzheimer's pathology. Cognitive scores (MMSE 29, MoCA 27) are normal, and the absence of APOE4 further reduces Alzheimer's risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** High",
  "timestamp": "2025-07-26T15:36:10.614507"
}