{
  "ptid_time": "031_S_0351_2008-04-21",
  "img_path": "/data/qiuhui/data/adni/images/031_S_0351/2008-04-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,045 mm³, 9.0% below the reference mean. With a Z-score of -0.22 (41.5th percentile), this represents normal volume ; hippocampal volume measures 6,119 mm³, 19.1% below the reference mean. With a Z-score of -1.86 (3.2th percentile), this represents moderate atrophy; whole brain volume measures 1,162,620 mm³, 7.7% above the reference mean. With a Z-score of 1.00 (84.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,481 mm³, 39.5% below the reference mean. With a Z-score of -2.68 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 18,678 mm³, 0.9% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,387 mm³, 13.8% below the reference mean. With a Z-score of -1.24 (10.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 70.4 years. Gender is Male. Education: 18 years. MMSE: 27.0. Logical Memory: 4.0. Laboratory findings: GGT: 40.00 (significant elevated); ALT (SGPT): 46.00 (profound elevated); AST (SGOT): 43.00 (profound elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show moderate to significant atrophy (Z-scores of -1.86 and -2.68, respectively), which are key regions affected in Alzheimer's disease. The MMSE score of 27 is within the normal range, but structural atrophy in these regions suggests early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to normal MMSE but significant atrophy in AD-vulnerable regions)",
  "timestamp": "2025-07-26T04:35:56.471373"
}