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aphy as well as adult stress and fetal echo accreditation is a two part process each facility will conduct a detailed self evaluation paying close attention to the iac standards and guidelines the facility will then complete the application and submit actual case studies to the board of directors for review once all requirements have been met the lab will receive certification iac certification is a continual process and must be maintained by the facility it may include audits or site visits by the iac there are several states in which medicare and or private insurance carriers require accreditation credentials of the laboratory and or sonographer for reimbursement of echocardiograms there are two credentialing bodies in the united states for sonographers the cardiovascular credentialing international cci established in 1968 and the american registry for diagnostic medical sonography ardms established in 1975 both cci and ardms have earned the prestigious ansi iso 17024 accreditation for certifying bodies from the international organization for standardization iso citation needed accreditation is granted through the american national standards institute ansi recognition of ardms programs in providing credentials has also earned the ardms accreditation with the national commission for certifying agencies ncca the ncca is the accrediting arm of the national organization for competency assurance noca under both credentialing bodies sonographers must first document completion of prerequisite requirements which contain both didactic and hands on experience in the field of ultrasound applicants must then take a comprehensive exam demonstrating knowledge in both the physics of ultrasound and the clinical competency related to their specialty credentialed sonographers are then required to maintain competency in their field by obtaining a certain number of continuing medical education credits or cme s in 2009 new mexico and oregon became the first two states to require licensure of sonographers citation needed the american society of echocardiography ase is a professional organization made up of physicians sonographers nurses and scientists involved in the field of echocardiography one of the most important roles that the ase plays is providing their recommendations through the ase guidelines and standards providing resource and educational opportunities for sonographers and physicians in the field there have been various institutes who are working on use of artificial intelligence in echo but they are at a very early stage and still needs full development 45 terminology edit the most commonly used terminology in echocardiography diagnostics are bsa body surface area dt deceleration time ivrt isovolumic relaxation time la left atrium ra right atrium lv left ventricle rv right ventricle lvot left ventricular outflow tract rvot right ventricular outflow tract pht pressure half time tapse tricuspid annular plane systolic excursion vc vena contracta edd end diastolic diameter esd end systolic diameter ivsd interventricular septal end diastole pwd posterior wall thickness lvmi left ventricular mass index ao asc ascending aorta st jxn sinotubular junction lavi left atrial volume index edv end diastolic volume esv end systolic volume ef ejection fraction fs fractional shortening ravi right atrial volume index rvot right ventricular outflow tract rvd basal rv diameter ivc inferior vena cava gls global longitudinal strain rvsp right ventricular systolic pressure e a ratio see also edit angiogram aortic valve area calculation electrocardiogram fetal echocardiography references edit cleve jayne mcculloch marti l 2018 conducting a cardiac ultrasound examination in nihoyannopoulos petros kisslo joseph eds echocardiography springer international publishing pp 33 42 doi 10 1007 978 3 319 71617 6_2 isbn 978 3319716176 a b oh j k 1 january 2007 echocardiography in heart failure beyond diagnosis european journal of echocardiography 8 1 4 14 doi 10 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