{
  "ptid_time": "027_S_0644_2008-06-25",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0644/2008-06-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 113,118 mm³, 193.7% above the reference mean. With a Z-score of 4.64 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,342 mm³, 16.1% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; whole brain volume measures 1,064,410 mm³, 1.4% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,608 mm³, 12.0% below the reference mean. With a Z-score of -0.81 (20.8th percentile), this represents normal volume ; fusiform gyrus volume measures 14,059 mm³, 25.4% below the reference mean. With a Z-score of -2.16 (1.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 17,559 mm³, 17.7% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 77.0 years. Gender is Male. Education: 14 years. MMSE: 29.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (193.7% above mean, Z=4.64) and significant atrophy in the fusiform gyrus (Z=-2.16) and moderate atrophy in the hippocampus (Z=-1.57) and middle temporal gyrus (Z=-1.59), which are hallmark structural changes in Alzheimer's disease. However, the MMSE score of 29 is within the normal range, suggesting preserved cognitive function despite these structural abnormalities.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes suggest early neurodegeneration, but cognition remains intact per MMSE).  \n\n**Confidence:** **Medium** (high confidence in structural pathology, but clinical correlation is needed due to the normal MMSE).  \n\n*Note: Given the severe atrophy in AD-vulnerable regions, this individual is at high risk for progression to dementia, but the current MMSE does not meet dementia criteria.*",
  "timestamp": "2025-07-26T03:40:34.051157"
}