$re = '/(?i)(<a)(?=((?:[^>"\']|"[^"]*"|\'[^\']*\')*?\shref\s*=\s*([\'"])\/mycms\/~\/link\.aspx\?_id=)([a-f0-9]{32})(&_z=z\3(?:"[\S\s]*?"|\'[\S\s]*?\'|[^>]*?)+>))\s+(?:"[\S\s]*?"|\'[\S\s]*?\'|[^>]*?)+>/';
$str = '<a hello world href="/mycms/~/link.aspx?_id=D9423CEFED254610A5DC6B096A297E17&_z=z" class>
...
</a>
<img hello world src="/mycms/~/media/B1FB91AC357347BD84913D56B8791D03.ashx" alt="" width="690" height="202" />
';
$subst = "$1$2key{$4}$5";
$result = preg_replace($re, $subst, $str, 1);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php