Chad,

As was said above, the best person to ask is your neurologist. Any opinions you get from here are worth exactly what you paid for them. With that said, here is what I see in the results you posted. The "hyperintense foci" they describe is just a fancy word for a bright spot on the scan. Bright spots on those types of MRI scans can be evidence of some process that is removing the protective coating (myelin) from the surface of the nerve tissue in your brain and spine. That is called dymelination and MS is a disease that can cause demyelination in the brain and spine. There are other processes and diseases that can cause it too, which is why the radiologist recommends "clinical correlation", which is simply matching the possible causes to your symptoms and other test results to determine what might explain the bright spots in the brain (also sometimes called lesions or plaques). The "periventricular white matter" can be a common location for lesions to show up in MRIs for patients with MS, but other diseases can cause similar appearance, so it is important for your neurologist to explore all the possibilities and eliminate other possibilities before reaching the diagnosis of MS.

As for the discussion of enhancement, during the MRI, they injected you with gadolinium to act as a contrast in the scans. In cases where the lesion is "active" or currently in the process of being demyelinated, it will "enhance" or get even brighter with the addition of the contrast. The lack of enhancement simply means that the bright spots or lesions you have on your scans were not actively getting worse at the time of the MRI scan.