Alfred Kratochwil graduated from the University of Vienna in 1953. He worked as a junior Obstetrician and Gynaecologist at the Second University Frauenklink, Vienna, Austria in the early 1960s. In 1964, he was studying the localization of the placenta using X-ray placentography and found much dissatisfaction at the interpretation. By chance, he attended a lecture by a neurosurgeon on the diagnosis of cerebral bleeding with ultrasound at the Society of Doctors in Vienna. He soon realised that this method could be applied to placental localisation. Kratochwil learned of a local ophthalmologist (Dr. Ossoinig) who had started scanning the eye using an A-scope from Kretztechnik®. He contacted Paul Kretz, owner and founder of the company, and was soon allowed the use of an A-mode equipment. He started with examining large genital cancers and found interpretation difficult. He then used the flaw-detector on placental localization, measurement of pelvic size and looking at fetal heart pulsations. Kratochwil scanned his patients for their placental location before delivery by caesarean section. He noted that the ultrasonic findings and the actual placental location correlated 90% of the time.
In December 1965, Kratochwil presented his findings on ultrasonic placentography at a meeting of the Austrian Society for Gynecology and Obstetrics. His findings were published in the following year in the German language. Although this was pioneering and gratifying work, Hofmann and Hollander in Munster, Germany had already had a similar presentation a month ahead of Kratochwil and they were using a B-mode realtime equipment the Vidoson® from Siemens of Germany, which had also incoporated a certain degree of gray-scale capability.
Kratochwil's lectures had at that time greatly influenced and encouraged European newcomers to ultrasonography such as Manfred Hansmann from Germany and Asim Kurjak from Croatia.
Following the placental studies Kratochwil proceeded with measurements of the Biparietal diameter. Using a proprietary vaginal scanner from KretzTechnik, Kratochwil's group identified fetal heart pulsation at slightly over 6 weeks menstrual age. He also developed a thimble attachment transducer to facilitate vaginal sonography with pelvic examination. His group further developed a special A-scan transducer with a central hole to enable amniocentesis to be carried out more safely.
Kratochwil soon learned of Ian Donald's work with the B-scan and quickly persuaded KretzTechnik to develop a similar device. This was a transistorised version without the heavy frame of the early Diasonograph and used an "elephant-trunk" articulated arm instead. Kratochwil found it much easier to manipulate than the Glasgow design. He initially used it on localizing pelvic recurrences in patients who had radical surgery for carcinoma of the cervix. In 1972, he demonstrated the visualisation of ovarian follicles with static B-mode ultrasound.
Kratochwil soon became one of the most prolific users of the instrument and worked on areas such as Internal Medicine, breast and other surgical conditions, where he also published a large number of important early papers so much so that readers at one time had thought he was a surgeon rather than an Obstetrician and Gynaecologist. Since 1968 he developed training courses in ultrasound in Vienna and his department was visited by many hundreds of radiologists and obstetricians in the next few years.
Kratochwil became Professor of Obstetrics and Gynaecology at the University Frauenklinik, Vienna, Austria in 1972. He has published over 300 papers many of them were in the German language. His first book, published in 1968 in the German language: "Ultraschall-diagnostik in Geburtshilfe und Gynkologie" representated one of the earliest textbooks on ultrasonography in this speciality. Work from Kratochwil's department touched on almost every facit of Obstetrical and Gynaecological sonography. He had also collaborated with Wilfried Feichtinger and Peter Kemeter on projects at the Institute of Sterility Treatment, Vienna.
In 1973, Professor Kratochwil founded the Austrian Ultrasound Society and he was also a Founding member of the European and World Federations of Ultrasound in Medicine and Biology. Between 1978 and 1981, he was President of the European Federation of Societies for Ultrasound in Medicine and Biology. Throughout the history of scanner development at Kretztechnik®, Professor Kratochwil has played key and pivotal roles in the clinical designs of the machines, running from their A-mode scanner to their static B-scanners, mechanical sector scanners, electronic real-times and the latest 3-dimensional machines. In 1992 he published on new 3-D developments at KretzTechnik in the article "Attempt at three-dimensional imaging in obstetrics" which appeared in the Journal "Ultraschall in Medicin". He wrote in the abstract:
"Different attempts have been already made to present sonographic findings in 3 dimensions. In most of computer assisted systems the time for acquiring and data processing is too long to allow for an instantaneous interaction between the examiner and the machine; furthermore, valuable data; concerning the organ structure were lost. The aim of the system presented here is to acquire short time a sample volume for 3 dimensional display without employing an expensive periphery, containing all relevant sonic data and without substantial changes in handling the equipment."
After his retirement from clinical Obstetrics and Gynaecology he still holds the title of Professor of Obstetrics and Gynaecology at the University of Vienna and now works mainly in the teaching and advancement of 3-dimensional Ultrasound. He is presently the Chairman of the Medison-Kretz 3-D Research Foundation and is active in many professional societies, organizations and congresses. Among many prizes and accolaides, he received the first Ian Donald Gold Medal from the International Society of Ultrasound in Obstetrics and Gynaecolgy (ISUOG) in 1991. He received this very first Medal from Mrs. Alix Donald, widow of the late Professor Ian Donald.
Back to History of Ultrasound in Obstetrics and Gynecology.