{
  "ptid_time": "032_S_4921_2013-04-04",
  "img_path": "/data/qiuhui/data/adni/images/032_S_4921/2013-04-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,325 mm³, 54.3% above the reference mean. With a Z-score of 1.29 (90.1th percentile), this represents mild enlargement; hippocampal volume measures 7,143 mm³, 11.0% below the reference mean. With a Z-score of -1.10 (13.6th percentile), this represents mild atrophy; whole brain volume measures 1,180,070 mm³, 4.0% above the reference mean. With a Z-score of 0.57 (71.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,643 mm³, 14.5% below the reference mean. With a Z-score of -1.01 (15.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,179 mm³, 18.7% below the reference mean. With a Z-score of -1.56 (6.0th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 21,678 mm³, 3.3% below the reference mean. With a Z-score of -0.27 (39.4th percentile), this represents normal volume . ",
  "text_data": "Age is 67.2 years. Gender is Male. Education: 20 years. MMSE: 28.0. MoCA: 26.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild to moderate atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus), while cognitive scores (MMSE 28, MoCA 26) remain within normal limits. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium**  \n\n*(Rationale: Structural atrophy suggests early neurodegeneration, but preserved cognition aligns with MCI. Confidence is medium due to the lack of longitudinal data or biomarker confirmation.)*",
  "timestamp": "2025-07-26T05:06:52.528844"
}