{
  "ptid_time": "016_S_0359_2008-07-15",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0359/2008-07-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,811 mm³, 13.9% below the reference mean. With a Z-score of -0.38 (35.3th percentile), this represents normal volume ; hippocampal volume measures 6,275 mm³, 3.4% below the reference mean. With a Z-score of -0.27 (39.3th percentile), this represents normal volume ; whole brain volume measures 754,464 mm³, 18.7% below the reference mean. With a Z-score of -2.25 (1.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,548 mm³, 26.4% below the reference mean. With a Z-score of -1.43 (7.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,358 mm³, 4.7% below the reference mean. With a Z-score of -0.35 (36.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,217 mm³, 21.1% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 83.3 years. Gender is Female. Education: 14 years. MMSE: 30.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant whole brain atrophy (Z-score -2.25, 1.2th percentile) and moderate atrophy in the middle temporal gyrus (Z-score -1.88, 3.0th percentile), with mild entorhinal cortex atrophy (Z-score -1.43, 7.7th percentile). However, hippocampal volume is normal (Z-score -0.27, 39.3th percentile), and MMSE is intact (30/30). Given the preserved cognition despite structural changes, this likely reflects age-related atrophy rather than dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to significant atrophy in some regions but intact cognition and normal hippocampal volume)",
  "timestamp": "2025-07-26T00:01:30.249844"
}