{
  "ptid_time": "072_S_4206_2014-09-22",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4206/2014-09-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 81,380 mm³, 111.3% above the reference mean. With a Z-score of 2.67 (99.6th percentile), this represents significant enlargement; hippocampal volume measures 6,764 mm³, 10.5% below the reference mean. With a Z-score of -1.03 (15.2th percentile), this represents mild atrophy; whole brain volume measures 1,038,440 mm³, 3.8% below the reference mean. With a Z-score of -0.49 (31.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,220 mm³, 2.9% above the reference mean. With a Z-score of 0.20 (57.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,512 mm³, 3.6% above the reference mean. With a Z-score of 0.30 (62.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,546 mm³, 5.7% above the reference mean. With a Z-score of 0.51 (69.4th percentile), this represents normal volume . ",
  "text_data": "Age is 71.6 years. Gender is Male. Education: 17 years. MMSE: 28.0. MoCA: 28.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant ventricular enlargement (Z-score 2.67) and mild hippocampal atrophy (Z-score -1.03), which are suggestive of neurodegenerative changes. However, cognitive scores (MMSE 28, MoCA 28) are within normal limits, and other brain regions (whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) show no significant atrophy.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes present but no significant cognitive decline yet).  \n**Confidence:** **Medium** (due to the discrepancy between imaging findings and preserved cognition; APOE4-negative status reduces Alzheimer's risk but does not rule out other causes of MCI).",
  "timestamp": "2025-07-26T09:18:56.307108"
}