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                                                                     EXHIBIT 4.4



                               FIRST AMENDMENT TO
                                RIGHTS AGREEMENT

                  This First Amendment to Rights Agreement (this "Amendment") is
made and entered into as of the 23rd day of January, 1996, by and between
MEDICAL IMAGING CENTERS OF AMERICA, INC., a California corporation (the
"Company"), and HARRIS TRUST COMPANY OF CALIFORNIA (the "Rights Agent").



                                    RECITALS

                  A.       Whereas, the Company and Union Bank entered into a 
Rights Agreement (the "Rights Agreement") dated as of October 2, 1991; and

                  B.  Whereas, Harris Trust Company of California has replaced 
Union Bank as Rights Agent under the Rights Agreement; and

                  C.       Whereas, Section 27 of the Rights Agreement provides
that, subject to certain conditions not applicable here, the Company may
supplement or amend any provision of the Rights Agreement without the approval
of any holders of Right Certificates representing shares of Common Stock; and

                  D.       Whereas, in October 1995, the Company effected a 
one-for-five reserve stock split (the "Reverse Stock Split") which had certain
effects on the Rights Agreement; and

                  E.       Whereas, based on the advice of counsel to the 
Company, the Board of Directors of the Company believes that certain changes to
the Rights Agreement, which among other things, provide greater flexibility for
the Company under the Rights Agreement and take into consideration the Reverse
Stock Split, are desirable and in the best interests of the Company and its
shareholders and has authorized certain amendments to the Rights Agreement in
the manner set forth herein;

                                    AGREEMENT

                  NOW THEREFORE, the Company and the Rights Agent hereby agree
as follows:

                  1.       Amendments.  The Rights Agreement is hereby amended 
as set forth below.

                           (a)      The first paragraph of Section 11(a)(ii) of
the Rights Agreement is hereby amended to read in its entirety as follows:

                                    "(ii) In the event any Person shall become
                  an Acquiring Person proper provision shall be made so that
                  each holder of a Right shall thereafter have a right to
                  receive, upon exercise thereof at a price equal to the then
                  current Purchase Price multiplied by the number of one
                  one-hundredths of a Preferred Share for which a Right is then
                  exercisable, in accordance with the terms of this Agreement,
                  such number of Common Shares of the Company as shall equal the
                  result obtained by (x) multiplying

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                  the then current Purchase Price by the number of one
                  one-hundredths of a Preferred Share for which a Right is then
                  exercisable and dividing that product by (y) 50% of the then
                  current per share market price of the Company's Common Shares
                  (determined pursuant to Section 11(d) hereof) on the date such
                  Person became an Acquiring Person (the "Adjustment Shares")."

                           (b)      Section 11(a)(iii) of the Rights Agreement 
is hereby amended to read in its entirety as follows:

                           "(iii) In the event that there shall not be
                  sufficient Common Shares issued but not outstanding or
                  authorized but unissued to permit the exercise in full of the
                  Rights in accordance with the foregoing subparagraph (ii), the
                  Company shall take all such action as may be necessary to
                  authorize additional Common Shares for issuance upon exercise
                  of the Rights; provided, however, that if the Company
                  determines that it is unable to cause the authorization of a
                  sufficient number of additional Common Shares, then, in the
                  event the Rights become exercisable, the Company, with respect
                  to each Right and to the extent necessary and permitted by
                  applicable law and any agreements or instruments in effect on
                  the date hereof to which it is a party, shall: (A) determine
                  the excess of (1) the value of the Adjustment Shares issuable
                  upon the exercise of a Right (the "Current Value"), over (2)
                  the Purchase Price (such excess, the "Spread") and (B) with
                  respect to each Right, make adequate provision to substitute
                  for the Adjustment Shares, upon payment of the applicable
                  Purchase Price, (1) cash, (2) a reduction in the Purchase
                  Price, (3) Common Shares or other equity securities of the
                  Company (including, without limitation, shares, or units of
                  shares, of preferred stock which the Board of Directors of the
                  Company has deemed to have the same value as Common Shares)
                  (each such share of preferred stock constituting a "Common
                  Stock Equivalent")), (4) debt securities of the Company, (5)
                  other assets or (6) any combination of the foregoing having an
                  aggregate value equal to the Current Value, where such
                  aggregate value has been determined by the Board of Directors
                  of the Company based upon the advice of a nationally
                  recognized investment banking firm selected by the Board of
                  Directors of the Company; provided, however, that if the
                  Company shall not have made adequate provision to deliver
                  value pursuant to clause (B) above within thirty (30) days
                  following the first occurrence of the event described in
                  Section 11(a)(ii) above, then the Company shall be obligated
                  to deliver, upon the surrender for exercise of a Right and
                  without requiring payment of the Purchase Price, Common Shares
                  (to the extent available) and then, if necessary, cash, which
                  in the aggregate are equal to the Spread. If the Board of
                  Directors of the Company shall determine in good faith that it
                  is unlikely that sufficient additional Common Shares could be
                  authorized for issuance upon exercise in full of the Rights,
                  the thirty (30) day period set forth above may be extended and
                  re-extended to the extent necessary, but not more than ninety
                  (90) days following the first occurrence of the event listed
                  in Section 11(a)(ii) above, in order that the Company may seek
                  stockholder approval for the authorization of such additional
                  shares

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                  (such period as may be extended, the "Substitution Period").
                  To the extent that the Company determines that some action
                  need be taken pursuant to the first and/or second sentences of
                  this Section 11(a)(iii), the Company (x) shall provide that
                  such action shall apply uniformly to all outstanding Rights,
                  and (y) may suspend the exercisability of the Rights until the
                  expiration of the Substitution Period in order to seek any
                  authorization of additional shares and/or to decide the
                  appropriate form of distribution to be made pursuant to such
                  first sentence and to determine the value thereof. In the
                  event of any such suspension, the Company shall issue a public
                  announcement stating that the exercisability of the Rights has
                  been temporarily suspended as well as a public announcement at
                  such time as the suspension is no longer in effect. For
                  purposes of this Section 11(a)(iii), the value of a Common
                  Share shall be the current per share market price (as
                  determined pursuant to Section 11(d)) on the date of the first
                  occurrence of the event listed in Section 11(a)(ii) above and
                  the value of any Common Stock Equivalent shall be deemed to
                  have the same value as the Common Shares on such date.

                           (c)      Section 23(b) of the Rights Agreement is 
hereby amended to read in its entirety as follows:

                           "(b) The Board of Directors of the Company may, at
                  its option, at any time prior to, or within ten (10) days
                  after a Shares Acquisition Date, redeem all but not less than
                  all of the then outstanding Rights at a redemption price of
                  $.05 per Right (after giving effect to the Reverse Stock
                  Split), appropriately adjusted to reflect any stock split,
                  stock dividend or similar transaction occurring after the date
                  hereof (such redemption price being hereinafter referred to as
                  the "Redemption Price"). The redemption of the Rights by the
                  Board of Directors may be made effective at such time on such
                  basis and with such conditions as the Board of Directors in
                  its sole discretion may establish."

                           (d)      Section 24 of the Rights Agreement is hereby
amended to read in its entirety as follows:

                           "Section 24.  Exchange

                           (a) The Board of Directors of the Company may, at its
                  option, at any time after any Person becomes an Acquiring
                  Person, exchange all or part of the then outstanding and
                  exercisable Rights (which shall not include Rights that have
                  become void pursuant to the provisions of Section 11(a)(ii)
                  hereof) for Preferred Shares or Common Shares, at the option
                  of the Board of Directors of the Company, at an exchange ratio
                  of five one-hundredths of a Preferred Share or one Common
                  Share per Right (after giving effect to the Reverse Stock
                  Split), appropriately adjusted to reflect any stock split,
                  stock dividend or similar transaction occurring after the date
                  hereof (such exchange ratio being hereinafter referred to as
                  the "Exchange Ratio").

                           (b)  Immediately upon the action of the Board of 
                  Directors of the Company ordering the exchange of any Rights
                  pursuant to subsection (a) of

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                  this Section 24 and without any further action and without any
                  notice, the right to exercise such Rights shall terminate and
                  the only right thereafter of a holder of such Rights shall be
                  to receive that number of Preferred Shares or Common Shares,
                  at the option of the Board of Directors of the Company, equal
                  to the number of such Rights held by such holder multiplied by
                  the Exchange Ratio. The Company shall promptly give public
                  notice of any such exchange; provided, however, that the
                  failure to give, or any defect in, such notice shall not
                  affect the validity of such exchange. The Company promptly
                  shall mail a notice of any such exchange to all of the holders
                  of such Rights at their last addresses as they appear upon the
                  registry books of the Rights Agent. Any notice which is mailed
                  in the manner herein provided shall be deemed given, whether
                  or not the holder receives the notice. Each such notice of
                  exchange will state the method by which the exchange of the
                  Preferred Shares or Common Shares for Rights will be effected
                  and, in the event of any partial exchange, the number of
                  Rights which will be exchanged. Any partial exchange shall be
                  effected pro rata based on the number of Rights (other than
                  Rights which have become void pursuant to the provisions of
                  Section 11(a)(ii) hereof) held by each holder of Rights.

                           (c) In the event that there shall not be sufficient
                  Preferred Shares or Common Shares issued but not outstanding
                  or authorized but unissued to permit any exchange of Rights as
                  contemplated in accordance with this Section 24, the Company
                  shall take all such action as may be necessary to authorize
                  additional Preferred Shares or Common Shares for issuance upon
                  exchange of the Rights.

                           (d) The Company shall not be required to issue
                  fractions of Preferred Shares or Common Shares or to
                  distribute certificates which evidence fractional Preferred
                  Shares or Common Shares. In lieu of such fractional Preferred
                  Shares or Common Shares, the Company shall pay to the
                  registered holders of the Right Certificates with regard to
                  which such fractional Preferred Shares or Common Shares would
                  otherwise be issuable an amount in cash equal to the same
                  fraction of the current market value of a whole Preferred
                  Share or Common Share. For the purposes of this subsection
                  (e), the current market value of a whole Preferred Share or
                  Common Share shall be the closing price of a Preferred Share
                  or Common Share (as determined pursuant to the second sentence
                  of Section 11(d)(i) hereof) for the Trading Day immediately
                  after the public announcement by the Company that an exchange
                  is to be effected pursuant to this Section 24."

                  2.       No Other Changes. Except as specifically set forth
herein, no change to the Rights Purchase Agreement is intended by the parties
hereto. Except as modified hereby, the parties to the Rights Agreement hereby
reaffirm in all respects all of the covenants, agreements, terms and conditions
set forth in the Rights Agreement, which are incorporated in full herein by
reference, and all terms, conditions and provisions thereof shall remain in full
force and effect, except as amended hereby.




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                  3.       Miscellaneous.  The headings and titles of this 
Amendment are for convenience only and do not constitute a part hereof. This
Amendment shall be governed by and construed in accordance with the laws of the
State of California. This may be executed in any number of counterparts, any one
of which shall be deemed to be an original and all of which together shall
constitute one and the same instrument.

                  IN WITNESS WHEREOF, the parties have executed this Amendment
as of the day and year first above written.


                           THE COMPANY:


                                   MEDICAL IMAGING CENTERS OF AMERICA, INC.,
                                   a California corporation




                                   By: /s/ Robert S. Muehlberg
                                      ------------------------------------------
                                           Name: Robert S. Muehlberg
                                           Its:  President and Chief Executive 
                                                   Officer


                           THE RIGHTS AGENT:

                                   HARRIS TRUST COMPANY OF CALIFORNIA

                                   By: /s/ Michael Goedecke
                                      ------------------------------------------
                                           Name: Michael Goedecke
                                           Its:  Vice President




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