$pattern = '/alt="" width="\d+" height="\d+"/i';
$replacement = 'alt="Poster"';
$variable = preg_replace($pattern, $replacement, $variable);
исправлена работа с любым порядком атрибутов (комментарий Гордона):
$pattern = '/alt=""/i';
$replacement = 'alt="Poster"';
$variable = preg_replace($pattern, $replacement, $variable);
$pattern = '/width="\d+"/i';
$replacement = '';
$variable = preg_replace($pattern, $replacement, $variable);
$pattern = '/height="\d+"/i';
$replacement = '';
$variable = preg_replace($pattern, $replacement, $variable);