{
  "ptid_time": "016_S_0702_2008-02-27",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0702/2008-02-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 85,345 mm³, 81.5% above the reference mean. With a Z-score of 2.37 (99.1th percentile), this represents significant enlargement; hippocampal volume measures 5,209 mm³, 25.2% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; whole brain volume measures 904,209 mm³, 12.1% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,919 mm³, 51.7% below the reference mean. With a Z-score of -3.38 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,167 mm³, 10.5% below the reference mean. With a Z-score of -0.91 (18.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,573 mm³, 3.0% below the reference mean. With a Z-score of -0.27 (39.5th percentile), this represents normal volume . ",
  "text_data": "Age is 86.5 years. Gender is Male. Education: 16 years. MMSE: 28.0. Laboratory findings: Total Bilirubin: 0.80 (significant elevated); Alkaline Phosphatase: 115.00 (significant elevated); Creatinine (Rate Blanked): 1.40 (significant elevated); AST (SGOT): 14.00 (significant reduced). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal and entorhinal cortex atrophy, both hallmark features of Alzheimer's disease (AD), alongside moderate whole-brain atrophy and severe ventricular enlargement (consistent with neurodegeneration). However, the MMSE score of 28 is within the normal range, suggesting preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (High confidence in neurodegeneration, but the discrepancy between imaging and MMSE suggests early-stage MCI rather than overt dementia. APOE4 carrier status and age further support AD-related pathology.)  \n\n*Note: A follow-up neuropsychological assessment (e.g., episodic memory testing) would strengthen the diagnosis, as MMSE alone may miss subtle deficits.*",
  "timestamp": "2025-07-26T00:04:09.709691"
}