{
  "ptid_time": "128_S_0258_2006-04-06",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0258/2006-04-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,489 mm³, 72.8% above the reference mean. With a Z-score of 1.67 (95.2th percentile), this represents moderate enlargement; hippocampal volume measures 5,909 mm³, 16.9% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; whole brain volume measures 1,082,620 mm³, 11.1% above the reference mean. With a Z-score of 1.39 (91.8th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,829 mm³, 23.0% below the reference mean. With a Z-score of -1.41 (7.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,158 mm³, 10.9% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,899 mm³, 3.8% above the reference mean. With a Z-score of 0.33 (62.9th percentile), this represents normal volume . ",
  "text_data": "Age is 71.3 years. Gender is Female. Education: 14 years. MMSE: 29.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal and entorhinal cortex atrophy, which are key regions affected in Alzheimer's disease (AD), along with ventricular enlargement suggestive of neurodegeneration. However, the MMSE score of 29 is within the normal range, and whole brain volume is mildly enlarged, which may indicate preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given structural AD-like atrophy but intact cognition on MMSE).  \n**Confidence:** **Medium** (due to conflicting findings—significant atrophy but normal MMSE).  \n\n*Note: APOE4 carrier status increases AD risk, but cognitive performance remains intact, making early MCI more likely than dementia at this stage.*",
  "timestamp": "2025-07-26T13:42:33.130244"
}