{
  "ptid_time": "126_S_4514_2019-05-28",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4514/2019-05-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 68,094 mm³, 142.6% above the reference mean. With a Z-score of 3.27 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 7,879 mm³, 10.7% above the reference mean. With a Z-score of 0.99 (83.8th percentile), this represents normal volume ; whole brain volume measures 972,454 mm³, 0.2% below the reference mean. With a Z-score of -0.03 (48.9th percentile), this represents normal volume ; entorhinal cortex volume measures 4,634 mm³, 26.2% above the reference mean. With a Z-score of 1.61 (94.6th percentile), this represents moderate enlargement; fusiform gyrus volume measures 16,418 mm³, 3.5% below the reference mean. With a Z-score of -0.32 (37.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,676 mm³, 2.6% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume . ",
  "text_data": "Age is 75.1 years. Gender is Female. Education: 14 years. MMSE: 29.0. MoCA: 22.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.27), which is strongly associated with neurodegeneration, while hippocampal volume is normal (Z-score 0.99). The MMSE (29/30) is normal, but the MoCA (22/30) suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **MCI** (likely amnestic subtype given MoCA performance, with ventricular enlargement suggesting early neurodegenerative changes).  \n\n**Confidence:** **Medium** (ventricular enlargement is concerning, but hippocampal volume is preserved; MoCA is borderline, and clinical correlation would help confirm).",
  "timestamp": "2025-07-26T12:48:07.071483"
}