{
  "ptid_time": "068_S_2248_2011-07-12",
  "img_path": "/data/qiuhui/data/adni/images/068_S_2248/2011-07-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,450 mm³, 20.6% above the reference mean. With a Z-score of 0.49 (68.9th percentile), this represents normal volume ; hippocampal volume measures 6,361 mm³, 15.9% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; whole brain volume measures 873,339 mm³, 19.1% below the reference mean. With a Z-score of -2.48 (0.7th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,993 mm³, 27.0% below the reference mean. With a Z-score of -1.83 (3.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,384 mm³, 23.6% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 19,324 mm³, 9.4% below the reference mean. With a Z-score of -0.85 (19.8th percentile), this represents normal volume . ",
  "text_data": "Age is 76.6 years. Gender is Male. Education: 12 years. MMSE: 28.0. MoCA: 24.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated); LDH: 240.00 (significant elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in whole brain volume and fusiform gyrus, along with moderate atrophy in the hippocampus and entorhinal cortex—key regions affected in Alzheimer’s disease (AD). Despite high MMSE (28/30), the MoCA (24/30) suggests subtle cognitive deficits, and the presence of one APOE4 allele increases AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer’s pathology).  \n\n**Confidence:** **High** (structural atrophy pattern and cognitive scores align with MCI, though the high MMSE slightly masks severity).  \n\n**Note:** The discrepancy between MMSE (near-normal) and MoCA (mild impairment) is common in early MCI; MoCA is more sensitive to executive/visuospatial deficits seen in AD. Follow-up with CSF biomarkers or amyloid PET could clarify progression risk.",
  "timestamp": "2025-07-26T08:56:40.956190"
}